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ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 401k Plan overview

Plan NameADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN
Plan identification number 501

ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:ADELANTE HEALTHCARE INC
Employer identification number (EIN):860377821
NAIC Classification:621491
NAIC Description:HMO Medical Centers

Additional information about ADELANTE HEALTHCARE INC

Jurisdiction of Incorporation: Arizona Corporation Commission
Incorporation Date:
Company Identification Number: 01284694

More information about ADELANTE HEALTHCARE INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01AUDREY M. BOHANAN2023-04-13
5012021-01-01AUDREY M. BOHANAN2022-06-06
5012020-01-01AUDREY M. BOHANAN2021-07-08
5012020-01-01AUDREY M. BOHANAN2021-09-01
5012019-01-01AUDREY BOHANAN2020-03-10
5012018-01-01
5012017-01-01
5012016-01-01AUDREY BOHANAN AUDREY BOHANAN2017-06-30
5012015-01-01AUDREY BOHANAN AUDREY BOHANAN2016-07-18
5012014-01-01AUDREY BOHANAN AUDREY BOHANAN2015-07-23
5012013-01-01AUDREY BOHANAN AUDREY BOHANAN2014-07-22
5012012-01-01AUDREY BOANAN AUDREY BOANAN2013-07-08
5012011-01-01AUDREY BOHANAN AUDREY BOHANAN2012-10-11
5012009-01-01TIFFANIE DILLARD
5012008-01-01
5012008-01-01

Plan Statistics for ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN

401k plan membership statisitcs for ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN

Measure Date Value
2022: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01717
Total number of active participants reported on line 7a of the Form 55002022-01-01830
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01832
Number of employers contributing to the scheme2022-01-010
2021: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01486
Total number of active participants reported on line 7a of the Form 55002021-01-01513
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0134
Total of all active and inactive participants2021-01-01548
Number of employers contributing to the scheme2021-01-010
2020: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01489
Total number of active participants reported on line 7a of the Form 55002020-01-01493
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01493
Number of employers contributing to the scheme2020-01-010
2019: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01489
Total number of active participants reported on line 7a of the Form 55002019-01-01489
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01489
Number of employers contributing to the scheme2019-01-010
2018: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01418
Total number of active participants reported on line 7a of the Form 55002018-01-01382
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01382
Number of employers contributing to the scheme2018-01-010
2017: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01445
Total number of active participants reported on line 7a of the Form 55002017-01-01370
Number of retired or separated participants receiving benefits2017-01-012
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01372
2016: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01396
Total number of active participants reported on line 7a of the Form 55002016-01-01445
Total of all active and inactive participants2016-01-01445
2015: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01242
Total number of active participants reported on line 7a of the Form 55002015-01-01371
Number of retired or separated participants receiving benefits2015-01-012
Total of all active and inactive participants2015-01-01373
2014: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01197
Total number of active participants reported on line 7a of the Form 55002014-01-01274
Number of retired or separated participants receiving benefits2014-01-013
Total of all active and inactive participants2014-01-01277
2013: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01226
Total number of active participants reported on line 7a of the Form 55002013-01-01227
Total of all active and inactive participants2013-01-01227
2012: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01150
Total number of active participants reported on line 7a of the Form 55002012-01-01226
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0110
Total of all active and inactive participants2012-01-01236
2011: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01164
Total number of active participants reported on line 7a of the Form 55002011-01-01150
Total of all active and inactive participants2011-01-01150
2009: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-010
Total number of active participants reported on line 7a of the Form 55002009-01-01175
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-010
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Form 5500 Responses for ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN

2022: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: ADELANTE HEALTHCARE INC HEALTH & WELFARE PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 3
Insurance contract or identification numberGL154819
Number of Individuals Covered717
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,507
Total amount of fees paid to insurance companyUSD $10,167
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $632,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,507
Amount paid for insurance broker fees10167
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
CURALINC HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberN/A
Policy instance 2
Insurance contract or identification numberN/A
Number of Individuals Covered798
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $12,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered584
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,071
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,071
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 4
Insurance contract or identification numberGL154819
Number of Individuals Covered633
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,358
Total amount of fees paid to insurance companyUSD $7,258
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $508,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,358
Amount paid for insurance broker fees7258
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
HEALTHJOY, LLC (National Association of Insurance Commissioners NAIC id number: 51121 )
Policy contract numberN/A
Policy instance 3
Insurance contract or identification numberN/A
Number of Individuals Covered513
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
COUNSELING & FAMILY RESOURCES, LTD, DBA EAP PREFERRED (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15135049
Policy instance 2
Insurance contract or identification number15135049
Number of Individuals Covered700
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $8,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered523
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,564
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,564
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered419
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,815
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,815
Amount paid for insurance broker fees0
Insurance broker organization code?3
COUNSELING & FAMILY RESOURCES, LTD, DBA EAP PREFERRED (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15135049
Policy instance 2
Insurance contract or identification number15135049
Number of Individuals Covered418
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $6,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 3
Insurance contract or identification numberGL154819
Number of Individuals Covered493
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,575
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $362,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,575
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTHJOY, LLC (National Association of Insurance Commissioners NAIC id number: 51121 )
Policy contract number00
Policy instance 3
Insurance contract or identification number00
Number of Individuals Covered616
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $44,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 4
Insurance contract or identification numberGL154819
Number of Individuals Covered493
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,575
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $362,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,575
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 3
Insurance contract or identification numberGL154819
Number of Individuals Covered489
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $13,468
Total amount of fees paid to insurance companyUSD $3,785
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $327,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,468
Amount paid for insurance broker fees3785
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
COUNSELING & FAMILY RESOURCES, LTD, DBA EAP PREFERRED (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15135049
Policy instance 2
Insurance contract or identification number15135049
Number of Individuals Covered418
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $8,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered419
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,815
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,815
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered377
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,751
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,751
Amount paid for insurance broker fees0
Insurance broker organization code?3
COUNSELING & FAMILY RESOURCES, LTD, DBA EAP PREFERRED (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberADELL123
Policy instance 2
Insurance contract or identification numberADELL123
Number of Individuals Covered382
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $5,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 3
Insurance contract or identification numberGL154819
Number of Individuals Covered494
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $12,206
Total amount of fees paid to insurance companyUSD $5,852
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $252,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,206
Amount paid for insurance broker fees5852
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL154819
Policy instance 4
Insurance contract or identification numberGL154819
Number of Individuals Covered457
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,202
Total amount of fees paid to insurance companyUSD $6,958
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $195,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,202
Amount paid for insurance broker fees6958
Additional information about fees paid to insurance brokerOTHER FEES, ADMIN AND OTHER FEES
Insurance broker organization code?3
Insurance broker nameLOVITT & TOUCHE, INC.
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERLL15100945
Policy instance 3
Insurance contract or identification numberERLL15100945
Number of Individuals Covered370
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $761,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
COUNSELING & FAMILY RESOURCES, LTD, DBA EAP PREFERRED (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberADELL123
Policy instance 2
Insurance contract or identification numberADELL123
Number of Individuals Covered418
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $5,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered365
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,701
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,701
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOVITT & TOUCHE, INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered275
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,489
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,489
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERL L15100945
Policy instance 2
Insurance contract or identification numberERL L15100945
Number of Individuals Covered371
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $483,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767365G
Policy instance 3
Insurance contract or identification number767365G
Number of Individuals Covered389
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $18,010
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $163,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,010
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403996 0010
Policy instance 2
Insurance contract or identification number403996 0010
Number of Individuals Covered220
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $438,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767365G
Policy instance 3
Insurance contract or identification number767365G
Number of Individuals Covered291
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,787
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $137,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,787
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered226
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,346
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,346
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered170
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,004
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,004
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767365G
Policy instance 2
Insurance contract or identification number767365G
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,552
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $105,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,552
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number730742
Policy instance 3
Insurance contract or identification number730742
Number of Individuals Covered189
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,494
Total amount of fees paid to insurance companyUSD $1,046
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,494
Amount paid for insurance broker fees1046
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767365G
Policy instance 2
Insurance contract or identification number767365G
Number of Individuals Covered228
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,091
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $100,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,091
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number730742
Policy instance 3
Insurance contract or identification number730742
Number of Individuals Covered180
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $8,620
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,620
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered171
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,012
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,012
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number730742
Policy instance 3
Insurance contract or identification number730742
Number of Individuals Covered456
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $38,320
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $958,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767365G
Policy instance 2
Insurance contract or identification number767365G
Number of Individuals Covered256
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $8,676
Total amount of fees paid to insurance companyUSD $2,047
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $86,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered167
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $914
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30005912
Policy instance 1
Insurance contract or identification number30005912
Number of Individuals Covered129
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $835
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,375
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $835
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05714044
Policy instance 2
Insurance contract or identification numberKM05714044
Number of Individuals Covered480
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,065
Total amount of fees paid to insurance companyUSD $4,014
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $199,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,065
Amount paid for insurance broker fees4014
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number706938
Policy instance 3
Insurance contract or identification number706938
Number of Individuals Covered124
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $31,146
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $786,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,146
Insurance broker organization code?3
Insurance broker nameLOVITT TOUCHE INC

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