UTAH MEDICAL PRODUCTS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN
401k plan membership statisitcs for UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 118 |
| Total of all active and inactive participants | 2022-01-01 | 118 |
| Total participants | 2022-01-01 | 118 |
| 2021: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 115 |
| Total of all active and inactive participants | 2021-01-01 | 115 |
| Total participants | 2021-01-01 | 115 |
| 2020: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 120 |
| Total of all active and inactive participants | 2020-01-01 | 120 |
| Total participants | 2020-01-01 | 120 |
| 2019: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 122 |
| Total of all active and inactive participants | 2019-01-01 | 122 |
| Total participants | 2019-01-01 | 122 |
| Number of participants with account balances | 2019-01-01 | 0 |
| 2018: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 120 |
| Total of all active and inactive participants | 2018-03-01 | 120 |
| Total participants | 2018-03-01 | 120 |
| 2017: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 115 |
| Total of all active and inactive participants | 2017-03-01 | 115 |
| Total participants | 2017-03-01 | 115 |
| 2016: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 121 |
| Total of all active and inactive participants | 2016-03-01 | 121 |
| Total participants | 2016-03-01 | 121 |
| 2015: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 130 |
| Total of all active and inactive participants | 2015-03-01 | 130 |
| Total participants | 2015-03-01 | 0 |
| 2014: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 125 |
| Total of all active and inactive participants | 2014-03-01 | 125 |
| Total participants | 2014-03-01 | 0 |
| 2013: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 131 |
| Total of all active and inactive participants | 2013-03-01 | 131 |
| Total participants | 2013-03-01 | 0 |
| 2012: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 133 |
| Total of all active and inactive participants | 2012-03-01 | 133 |
| Total participants | 2012-03-01 | 0 |
| 2011: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 132 |
| Total of all active and inactive participants | 2011-03-01 | 132 |
| Total participants | 2011-03-01 | 132 |
| 2010: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 132 |
| Total of all active and inactive participants | 2010-01-01 | 132 |
| 2009: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 138 |
| Total of all active and inactive participants | 2009-01-01 | 138 |
| Total participants | 2009-01-01 | 0 |
| 2022: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: UTAH MEDICAL PRODUCTS, INC. FLEXIBLE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-03-01 | | Total amount of fees paid to insurance company | USD $3,101 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3101 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-03-01 | | Total amount of fees paid to insurance company | USD $1,268 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $12,680 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1268 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-03-01 | | Total amount of fees paid to insurance company | USD $1,329 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1329 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $3,095 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,095 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $1,328 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,280 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,328 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $1,291 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,291 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of fees paid to insurance company | USD $3,055 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3055 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of fees paid to insurance company | USD $1,326 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1326 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of commissions paid to insurance broker | USD $1,279 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,993 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,279 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $2,965 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,965 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $1,366 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,655 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,366 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $1,317 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,317 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $2,699 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,699 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $1,330 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,300 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,330 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $1,254 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,254 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0ACJ3 |
| Policy instance | 3 |
| Insurance contract or identification number | GVTL0ACJ3 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $2,410 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,410 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLER INVESTMENT & INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0ACJ3 |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0ACJ3 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $1,302 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,302 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLER INVESTMENT & INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD0ACJ3 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD0ACJ3 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $1,193 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,910 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,193 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD; OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLER INVESTMENT & INSURANCE |
|
