CODA, INC. has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2022: CODA HEALTH PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-10-01 | 139 |
Number of retired or separated participants receiving benefits | 2022-10-01 | 177 |
Total of all active and inactive participants | 2022-10-01 | 177 |
2021: CODA HEALTH PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-10-01 | 151 |
Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 139 |
Total of all active and inactive participants | 2021-10-01 | 139 |
2020: CODA HEALTH PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-10-01 | 174 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 151 |
Total of all active and inactive participants | 2020-10-01 | 151 |
2019: CODA HEALTH PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-10-01 | 167 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 174 |
Total of all active and inactive participants | 2019-10-01 | 174 |
2018: CODA HEALTH PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-10-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 167 |
Total of all active and inactive participants | 2018-10-01 | 167 |
2017: CODA HEALTH PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-10-01 | 193 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 166 |
Total of all active and inactive participants | 2017-10-01 | 166 |
2016: CODA HEALTH PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-10-01 | 191 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 193 |
Total of all active and inactive participants | 2016-10-01 | 193 |
2015: CODA HEALTH PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-10-01 | 150 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 164 |
Total of all active and inactive participants | 2015-10-01 | 164 |
2014: CODA HEALTH PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-10-01 | 153 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 150 |
Total of all active and inactive participants | 2014-10-01 | 150 |
2013: CODA HEALTH PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-10-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 153 |
Total of all active and inactive participants | 2013-10-01 | 153 |
2012: CODA HEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-10-01 | 143 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 147 |
Total of all active and inactive participants | 2012-10-01 | 147 |
2011: CODA HEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-10-01 | 139 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 143 |
Total of all active and inactive participants | 2011-10-01 | 143 |
2009: CODA HEALTH PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-10-01 | 130 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 133 |
Total of all active and inactive participants | 2009-10-01 | 133 |
2022: CODA HEALTH PLAN 2022 form 5500 responses |
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2022-10-01 | Type of plan entity | Single employer plan |
2022-10-01 | Plan funding arrangement – Insurance | Yes |
2022-10-01 | Plan benefit arrangement – Insurance | Yes |
2021: CODA HEALTH PLAN 2021 form 5500 responses |
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2021-10-01 | Type of plan entity | Single employer plan |
2021-10-01 | Plan funding arrangement – Insurance | Yes |
2021-10-01 | Plan benefit arrangement – Insurance | Yes |
2020: CODA HEALTH PLAN 2020 form 5500 responses |
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2020-10-01 | Type of plan entity | Single employer plan |
2020-10-01 | Plan funding arrangement – Insurance | Yes |
2020-10-01 | Plan benefit arrangement – Insurance | Yes |
2019: CODA HEALTH PLAN 2019 form 5500 responses |
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2019-10-01 | Type of plan entity | Single employer plan |
2019-10-01 | Plan funding arrangement – Insurance | Yes |
2019-10-01 | Plan benefit arrangement – Insurance | Yes |
2018: CODA HEALTH PLAN 2018 form 5500 responses |
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2018-10-01 | Type of plan entity | Single employer plan |
2018-10-01 | Plan funding arrangement – Insurance | Yes |
2018-10-01 | Plan benefit arrangement – Insurance | Yes |
2017: CODA HEALTH PLAN 2017 form 5500 responses |
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2017-10-01 | Type of plan entity | Single employer plan |
2017-10-01 | Plan funding arrangement – Insurance | Yes |
2017-10-01 | Plan benefit arrangement – Insurance | Yes |
2016: CODA HEALTH PLAN 2016 form 5500 responses |
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2016-10-01 | Type of plan entity | Single employer plan |
2016-10-01 | Plan funding arrangement – Insurance | Yes |
2016-10-01 | Plan benefit arrangement – Insurance | Yes |
2015: CODA HEALTH PLAN 2015 form 5500 responses |
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2015-10-01 | Type of plan entity | Single employer plan |
2015-10-01 | Plan funding arrangement – Insurance | Yes |
2015-10-01 | Plan benefit arrangement – Insurance | Yes |
2014: CODA HEALTH PLAN 2014 form 5500 responses |
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2014-10-01 | Type of plan entity | Single employer plan |
2014-10-01 | Plan funding arrangement – Insurance | Yes |
2014-10-01 | Plan benefit arrangement – Insurance | Yes |
2013: CODA HEALTH PLAN 2013 form 5500 responses |
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2013-10-01 | Type of plan entity | Single employer plan |
2013-10-01 | Plan funding arrangement – Insurance | Yes |
2013-10-01 | Plan benefit arrangement – Insurance | Yes |
2012: CODA HEALTH PLAN 2012 form 5500 responses |
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2012-10-01 | Type of plan entity | Single employer plan |
2012-10-01 | Plan funding arrangement – Insurance | Yes |
2012-10-01 | Plan benefit arrangement – Insurance | Yes |
2011: CODA HEALTH PLAN 2011 form 5500 responses |
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2011-10-01 | Type of plan entity | Single employer plan |
2011-10-01 | Plan funding arrangement – Insurance | Yes |
2011-10-01 | Plan benefit arrangement – Insurance | Yes |
2009: CODA HEALTH PLAN 2009 form 5500 responses |
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2009-10-01 | Type of plan entity | Single employer plan |
2009-10-01 | This submission is the final filing | No |
2009-10-01 | Plan funding arrangement – Insurance | Yes |
2009-10-01 | Plan benefit arrangement – Insurance | Yes |
2008: CODA HEALTH PLAN 2008 form 5500 responses |
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2008-10-01 | Type of plan entity | Single employer plan |
2008-10-01 | Submission has been amended | No |
2008-10-01 | This submission is the final filing | No |
2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-10-01 | Plan is a collectively bargained plan | No |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000C743 |
Policy instance | 3 |
Insurance contract or identification number | G000C743 | Number of Individuals Covered | 177 | Insurance policy start date | 2022-11-01 | Insurance policy end date | 2023-11-01 | Total amount of commissions paid to insurance broker | USD $14,139 | Total amount of fees paid to insurance company | USD $888 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS VOLUNTARY, ACCIDEN | Welfare Benefit Premiums Paid to Carrier | USD $141,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,139 | Amount paid for insurance broker fees | 888 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 138 | Insurance policy start date | 2022-11-01 | Insurance policy end date | 2023-10-31 | Total amount of commissions paid to insurance broker | USD $1,193 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,628 | 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 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 172 | Insurance policy start date | 2022-11-01 | Insurance policy end date | 2023-10-31 | Total amount of commissions paid to insurance broker | USD $26,366 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $905,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,366 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 892033G |
Policy instance | 3 |
Insurance contract or identification number | 892033G | Number of Individuals Covered | 139 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $11,276 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $98,239 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,825 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 102 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $646 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,170 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $646 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 118 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $22,140 | Total amount of fees paid to insurance company | USD $3,038 | Welfare Benefit Premiums Paid to Carrier | USD $700,766 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,963 | Amount paid for insurance broker fees | 3038 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 147 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $39,233 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,298,264 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,233 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 94 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $1,022 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,120 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,022 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 892033G |
Policy instance | 3 |
Insurance contract or identification number | 892033G | Number of Individuals Covered | 151 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $13,885 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE AND ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $122,827 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,885 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 688612 |
Policy instance | 5 |
Insurance contract or identification number | 688612 | Number of Individuals Covered | 62 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-11-01 | Total amount of commissions paid to insurance broker | USD $1,399 | Total amount of fees paid to insurance company | USD $77 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $10,276 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,399 | Amount paid for insurance broker fees | 77 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 91847 |
Policy instance | 4 |
Insurance contract or identification number | 91847 | Number of Individuals Covered | 181 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-11-01 | Total amount of commissions paid to insurance broker | USD $2,203 | Total amount of fees paid to insurance company | USD $207 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $30,521 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,203 | Amount paid for insurance broker fees | 207 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 387066 |
Policy instance | 3 |
Insurance contract or identification number | 387066 | Number of Individuals Covered | 193 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-11-01 | Total amount of commissions paid to insurance broker | USD $8,646 | Total amount of fees paid to insurance company | USD $1,054 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $142,220 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,646 | Amount paid for insurance broker fees | 1054 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 92 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $1,061 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,017 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,061 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 174 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-30 | Total amount of commissions paid to insurance broker | USD $44,208 | Total amount of fees paid to insurance company | USD $768 | Welfare Benefit Premiums Paid to Carrier | USD $1,481,380 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,208 | Amount paid for insurance broker fees | 768 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 167 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-30 | Total amount of commissions paid to insurance broker | USD $37,212 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,242,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $37,212 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 74 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $862 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $862 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 387066 |
Policy instance | 3 |
Insurance contract or identification number | 387066 | Number of Individuals Covered | 202 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-11-01 | Total amount of commissions paid to insurance broker | USD $7,467 | Total amount of fees paid to insurance company | USD $690 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $125,658 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,467 | Amount paid for insurance broker fees | 690 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 91847 |
Policy instance | 4 |
Insurance contract or identification number | 91847 | Number of Individuals Covered | 200 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-11-01 | Total amount of commissions paid to insurance broker | USD $1,742 | Total amount of fees paid to insurance company | USD $138 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $29,915 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,742 | Amount paid for insurance broker fees | 138 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 0011662612 |
Policy instance | 5 |
Insurance contract or identification number | 0011662612 | Number of Individuals Covered | 53 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-11-01 | Total amount of commissions paid to insurance broker | USD $3,428 | Total amount of fees paid to insurance company | USD $184 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,776 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,372 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 130 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 0011662612 |
Policy instance | 5 |
Insurance contract or identification number | 0011662612 | Number of Individuals Covered | 22 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-11-01 | Total amount of commissions paid to insurance broker | USD $3,163 | Total amount of fees paid to insurance company | USD $157 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,144 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 91847 |
Policy instance | 4 |
Insurance contract or identification number | 91847 | Number of Individuals Covered | 155 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-11-01 | Total amount of commissions paid to insurance broker | USD $1,991 | Total amount of fees paid to insurance company | USD $172 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,799 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 387066 |
Policy instance | 3 |
Insurance contract or identification number | 387066 | Number of Individuals Covered | 156 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-11-01 | Total amount of commissions paid to insurance broker | USD $7,602 | Total amount of fees paid to insurance company | USD $759 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $109,988 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30036340 |
Policy instance | 2 |
Insurance contract or identification number | 30036340 | Number of Individuals Covered | 80 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $943 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,421 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1200 |
Policy instance | 1 |
Insurance contract or identification number | 1200 | Number of Individuals Covered | 166 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-30 | Total amount of commissions paid to insurance broker | USD $32,079 | Total amount of fees paid to insurance company | USD $903 | Welfare Benefit Premiums Paid to Carrier | USD $1,069,556 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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