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PACIFIC PROPERTIES-HEALTH PLAN 401k Plan overview

Plan NamePACIFIC PROPERTIES-HEALTH PLAN
Plan identification number 501

PACIFIC PROPERTIES-HEALTH PLAN Benefits

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

401k Sponsoring company profile

PACIFIC PROPERTIES AND DEVELOPMENT CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:PACIFIC PROPERTIES AND DEVELOPMENT CORPORATION
Employer identification number (EIN):880210631
NAIC Classification:531390
NAIC Description:Other Activities Related to Real Estate

Additional information about PACIFIC PROPERTIES AND DEVELOPMENT CORPORATION

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 1985-02-19
Company Identification Number: 19851002827
Legal Registered Office Address: 1645 VILLAGE CENTER CIRCLE STE 170

LAS VEGAS
United States of America (USA)
89134

More information about PACIFIC PROPERTIES AND DEVELOPMENT CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC PROPERTIES-HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01REINIER SANTANA2019-07-30
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01REINIER SANTANA
5012011-01-01REINIER SANTANA
5012010-01-01REINIER SANTANA
5012009-01-01REINIER SANTANA

Plan Statistics for PACIFIC PROPERTIES-HEALTH PLAN

401k plan membership statisitcs for PACIFIC PROPERTIES-HEALTH PLAN

Measure Date Value
2018: PACIFIC PROPERTIES-HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01353
Total number of active participants reported on line 7a of the Form 55002018-01-01353
Total of all active and inactive participants2018-01-01353
2017: PACIFIC PROPERTIES-HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01257
Total number of active participants reported on line 7a of the Form 55002017-01-01257
Total of all active and inactive participants2017-01-01257
2016: PACIFIC PROPERTIES-HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01252
Total number of active participants reported on line 7a of the Form 55002016-01-01257
Total of all active and inactive participants2016-01-01257
2015: PACIFIC PROPERTIES-HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01263
Total number of active participants reported on line 7a of the Form 55002015-01-01252
Total of all active and inactive participants2015-01-01252
2014: PACIFIC PROPERTIES-HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01195
Total number of active participants reported on line 7a of the Form 55002014-01-01263
Total of all active and inactive participants2014-01-01263
2013: PACIFIC PROPERTIES-HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01142
Total number of active participants reported on line 7a of the Form 55002013-01-01195
Total of all active and inactive participants2013-01-01195
2012: PACIFIC PROPERTIES-HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01168
Total number of active participants reported on line 7a of the Form 55002012-01-01142
Total of all active and inactive participants2012-01-01142
2011: PACIFIC PROPERTIES-HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01238
Total number of active participants reported on line 7a of the Form 55002011-01-01168
Total of all active and inactive participants2011-01-01168
2010: PACIFIC PROPERTIES-HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01253
Total number of active participants reported on line 7a of the Form 55002010-01-01238
Total of all active and inactive participants2010-01-01238
2009: PACIFIC PROPERTIES-HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01239
Total number of active participants reported on line 7a of the Form 55002009-01-01253
Total of all active and inactive participants2009-01-01253

Form 5500 Responses for PACIFIC PROPERTIES-HEALTH PLAN

2018: PACIFIC PROPERTIES-HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: PACIFIC PROPERTIES-HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PACIFIC PROPERTIES-HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: PACIFIC PROPERTIES-HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PACIFIC PROPERTIES-HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: PACIFIC PROPERTIES-HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: PACIFIC PROPERTIES-HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PACIFIC PROPERTIES-HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: PACIFIC PROPERTIES-HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: PACIFIC PROPERTIES-HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303663
Policy instance 3
Insurance contract or identification number303663
Number of Individuals Covered226
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,439
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,439
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered310
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $58,182
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,217,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,182
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 2
Insurance contract or identification number0729692
Number of Individuals Covered58
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,905
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,905
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303663
Policy instance 3
Insurance contract or identification number303663
Number of Individuals Covered134
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,460
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,460
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 2
Insurance contract or identification number0729692
Number of Individuals Covered140
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $9,753
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,753
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered252
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $47,544
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,013,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,544
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered263
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $29,046
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $933,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,046
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303663
Policy instance 3
Insurance contract or identification number303663
Number of Individuals Covered143
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,213
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,213
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 2
Insurance contract or identification number0729692
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,648
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,648
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number303663
Policy instance 4
Insurance contract or identification number303663
Number of Individuals Covered154
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $1,958
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,958
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 3
Insurance contract or identification number0729692
Number of Individuals Covered115
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,918
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,918
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH68560
Policy instance 2
Insurance contract or identification numberH68560
Number of Individuals Covered131
Insurance policy start date2013-01-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $610
Total amount of fees paid to insurance companyUSD $125
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $494
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered195
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $41,616
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $849,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,616
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH68560
Policy instance 2
Insurance contract or identification numberH68560
Number of Individuals Covered142
Insurance policy start date2012-07-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,627
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,627
Insurance broker nameINSURCORP
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered26
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $23,154
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,673
Insurance broker nameBROWN & BROWN INSURANCE OF NEVADA,
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered168
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $43,007
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $456,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH68560
Policy instance 3
Insurance contract or identification numberH68560
Number of Individuals Covered153
Insurance policy start date2011-07-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,364
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 2
Insurance contract or identification number0729692
Number of Individuals Covered29
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $7,440
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberGDT KM05555804
Policy instance 2
Insurance contract or identification numberGDT KM05555804
Number of Individuals Covered139
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,283
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,283
Insurance broker organization code?3
Insurance broker nameINSURCORP
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH68560
Policy instance 6
Insurance contract or identification numberH68560
Number of Individuals Covered172
Insurance policy start date2010-07-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $935
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $935
Insurance broker nameINSURCORP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0729692
Policy instance 5
Insurance contract or identification number0729692
Number of Individuals Covered140
Insurance policy start date2010-07-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,635
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,635
Insurance broker nameINSURCORP
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberGL KM05555804
Policy instance 4
Insurance contract or identification numberGL KM05555804
Number of Individuals Covered165
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,167
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,167
Insurance broker organization code?3
Insurance broker nameINSURCORP
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberGDD KM05555804
Policy instance 3
Insurance contract or identification numberGDD KM05555804
Number of Individuals Covered165
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $161
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $161
Insurance broker organization code?3
Insurance broker nameINSURCORP
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number10000664
Policy instance 1
Insurance contract or identification number10000664
Number of Individuals Covered238
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $54,190
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $847,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,190
Insurance broker nameINSURCORP

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