HAPO COMMUNITY CREDIT UNION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN
401k plan membership statisitcs for HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2022: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-05-01 | 434 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 462 |
| Number of retired or separated participants receiving benefits | 2022-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 0 |
| Total of all active and inactive participants | 2022-05-01 | 462 |
| Number of employers contributing to the scheme | 2022-05-01 | 0 |
| 2021: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-05-01 | 434 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 434 |
| Number of retired or separated participants receiving benefits | 2021-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
| Total of all active and inactive participants | 2021-05-01 | 434 |
| Number of employers contributing to the scheme | 2021-05-01 | 0 |
| 2020: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 434 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 434 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 434 |
| Number of employers contributing to the scheme | 2020-05-01 | 0 |
| 2019: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 430 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 420 |
| Number of retired or separated participants receiving benefits | 2019-05-01 | 2 |
| Total of all active and inactive participants | 2019-05-01 | 422 |
| 2018: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 378 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 429 |
| Total of all active and inactive participants | 2018-05-01 | 429 |
| 2017: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 352 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 378 |
| Total of all active and inactive participants | 2017-05-01 | 378 |
| 2016: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 343 |
| Number of retired or separated participants receiving benefits | 2016-05-01 | 5 |
| Total of all active and inactive participants | 2016-05-01 | 348 |
| 2015: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 315 |
| Number of retired or separated participants receiving benefits | 2015-05-01 | 4 |
| Total of all active and inactive participants | 2015-05-01 | 319 |
| 2014: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 298 |
| Total of all active and inactive participants | 2014-05-01 | 298 |
| 2013: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 319 |
| Total of all active and inactive participants | 2013-05-01 | 319 |
| 2012: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 272 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 303 |
| Number of retired or separated participants receiving benefits | 2012-05-01 | 4 |
| Total of all active and inactive participants | 2012-05-01 | 307 |
| 2011: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 272 |
| Total of all active and inactive participants | 2011-05-01 | 272 |
| 2010: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-05-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 246 |
| Number of retired or separated participants receiving benefits | 2010-05-01 | 1 |
| Total of all active and inactive participants | 2010-05-01 | 247 |
| 2009: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-05-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 200 |
| Total of all active and inactive participants | 2009-05-01 | 200 |
| 2008: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-05-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-05-01 | 191 |
| Number of retired or separated participants receiving benefits | 2008-05-01 | 1 |
| Total of all active and inactive participants | 2008-05-01 | 192 |
| 2007: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-05-01 | 150 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-05-01 | 163 |
| Total of all active and inactive participants | 2007-05-01 | 163 |
| 2006: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-05-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-05-01 | 150 |
| Total of all active and inactive participants | 2006-05-01 | 150 |
| 2005: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-05-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-05-01 | 145 |
| Number of retired or separated participants receiving benefits | 2005-05-01 | 2 |
| Total of all active and inactive participants | 2005-05-01 | 147 |
| 2004: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-05-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-05-01 | 130 |
| Total of all active and inactive participants | 2004-05-01 | 130 |
| 2022: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2022 form 5500 responses |
|---|
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2021 form 5500 responses |
|---|
| 2021-05-01 | Type of plan entity | Single employer plan |
| 2021-05-01 | Plan funding arrangement – Insurance | Yes |
| 2021-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2020 form 5500 responses |
|---|
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2019 form 5500 responses |
|---|
| 2019-05-01 | Type of plan entity | Single employer plan |
| 2019-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2010 form 5500 responses |
|---|
| 2010-05-01 | Type of plan entity | Single employer plan |
| 2010-05-01 | Plan funding arrangement – Insurance | Yes |
| 2010-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2009 form 5500 responses |
|---|
| 2009-05-01 | Type of plan entity | Single employer plan |
| 2009-05-01 | Plan funding arrangement – Insurance | Yes |
| 2009-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2008 form 5500 responses |
|---|
| 2008-05-01 | Type of plan entity | Single employer plan |
| 2008-05-01 | Plan funding arrangement – Insurance | Yes |
| 2008-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2007 form 5500 responses |
|---|
| 2007-05-01 | Type of plan entity | Single employer plan |
| 2007-05-01 | Plan funding arrangement – Insurance | Yes |
| 2007-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2006: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2006 form 5500 responses |
|---|
| 2006-05-01 | Type of plan entity | Single employer plan |
| 2006-05-01 | Plan funding arrangement – Insurance | Yes |
| 2006-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2006-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2006-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2005: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2005 form 5500 responses |
|---|
| 2005-05-01 | Type of plan entity | Single employer plan |
| 2005-05-01 | Plan funding arrangement – Insurance | Yes |
| 2005-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2005-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2005-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2004: HAPO COMMUNITY CREDIT UNION HEALTH BENEFITS PLAN 2004 form 5500 responses |
|---|
| 2004-05-01 | Type of plan entity | Single employer plan |
| 2004-05-01 | First time form 5500 has been submitted | Yes |
| 2004-05-01 | Plan funding arrangement – Insurance | Yes |
| 2004-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2004-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2004-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $1,954 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,954 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 443 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $1,925 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,925 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 427 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $92 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $92 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 429 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $1,870 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,870 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 429 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $1,813 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,771 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,813 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 378 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $1,699 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,691 | | 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: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 2 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $1,499 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,499 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES LLC |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 316 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $97,229 | | Total amount of fees paid to insurance company | USD $2,810 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,082,860 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $97,229 | | Amount paid for insurance broker fees | 2810 | | Additional information about fees paid to insurance broker | PREFERRED PRODUCER PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES LLC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 2 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 296 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $1,530 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,530 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $93,826 | | Total amount of fees paid to insurance company | USD $5,246 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,345,638 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $93,826 | | Amount paid for insurance broker fees | 5246 | | Additional information about fees paid to insurance broker | PREFERRED PRODUCER PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES LLC |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $83,208 | | Total amount of fees paid to insurance company | USD $4,007 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,026,120 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $83,208 | | Amount paid for insurance broker fees | 4007 | | Additional information about fees paid to insurance broker | PREFERRED PRODUCER PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 2 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $1,514 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,514 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERVICES |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $68,531 | | Total amount of fees paid to insurance company | USD $3,278 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,659,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,966 | | Amount paid for insurance broker fees | 1681 | | Additional information about fees paid to insurance broker | PREFERRED PRODUCER PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE -PASCO BRANCH |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 2 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $1,632 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,632 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE SERRVICES LLC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 272 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $1,511 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 2 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $59,634 | | Total amount of fees paid to insurance company | USD $2,738 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,445,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 882288-099 |
| Policy instance | 1 |
| Insurance contract or identification number | 882288-099 | | Number of Individuals Covered | 398 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $9,517 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $127,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,517 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
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| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 2 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $49,110 | | Total amount of fees paid to insurance company | USD $2,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,227,749 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,110 | | Amount paid for insurance broker fees | 2000 | | Additional information about fees paid to insurance broker | LEADERS PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 3 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $1,465 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,465 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-04-30 | | Total amount of commissions paid to insurance broker | USD $40,021 | | Total amount of fees paid to insurance company | USD $2,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,000,519 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,021 | | Amount paid for insurance broker fees | 2000 | | Additional information about fees paid to insurance broker | LEADERS PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
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| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 882288-099 |
| Policy instance | 2 |
| Insurance contract or identification number | 882288-099 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-04-30 | | Total amount of commissions paid to insurance broker | USD $7,907 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $104,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,907 | | Insurance broker name | CONOVER INSURANCE |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 3 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-04-30 | | Total amount of commissions paid to insurance broker | USD $1,310 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,310 | | Insurance broker organization code? | 2 | | Insurance broker name | CONOVER INSURANCE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2008-05-01 | | Insurance policy end date | 2009-04-30 | | Total amount of commissions paid to insurance broker | USD $1,254 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | 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 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 2 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2008-05-01 | | Insurance policy end date | 2009-04-30 | | Total amount of commissions paid to insurance broker | USD $34,783 | | Total amount of fees paid to insurance company | USD $3,500 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $869,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,783 | | Amount paid for insurance broker fees | 3500 | | Additional information about fees paid to insurance broker | LEADERS PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12070173 |
| Policy instance | 1 |
| Insurance contract or identification number | 12070173 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2007-05-01 | | Insurance policy end date | 2008-04-30 | | Total amount of commissions paid to insurance broker | USD $1,143 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,143 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 2 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2007-05-01 | | Insurance policy end date | 2008-04-30 | | Total amount of commissions paid to insurance broker | USD $26,740 | | Total amount of fees paid to insurance company | USD $2,000 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $668,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,740 | | Amount paid for insurance broker fees | 2000 | | Additional information about fees paid to insurance broker | LEADERS PROGRAM | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2007-05-01 | | Insurance policy end date | 2008-04-30 | | Total amount of commissions paid to insurance broker | USD $24,993 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $624,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,993 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
|
| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2005-05-01 | | Insurance policy end date | 2006-04-30 | | Total amount of commissions paid to insurance broker | USD $25,168 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $629,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,168 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE-PASCO BRANCH |
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| PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
| Policy contract number | 1000117 |
| Policy instance | 1 |
| Insurance contract or identification number | 1000117 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2004-05-01 | | Insurance policy end date | 2005-04-30 | | Total amount of commissions paid to insurance broker | USD $21,196 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $529,907 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,196 | | Insurance broker organization code? | 3 | | Insurance broker name | CONOVER INSURANCE |
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