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HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 401k Plan overview

Plan NameHEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR
Plan identification number 501

HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR Benefits

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

401k Sponsoring company profile

ADVOCATES FOR LIFE SKILLS AND OP has sponsored the creation of one or more 401k plans.

Company Name:ADVOCATES FOR LIFE SKILLS AND OP
Employer identification number (EIN):931234625
NAIC Classification:624310
NAIC Description:Vocational Rehabilitation Services

Additional information about ADVOCATES FOR LIFE SKILLS AND OP

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1997-12-15
Company Identification Number: 60866283
Legal Registered Office Address: 10541 SE CHERRY BLOSSOM DR

PORTLAND
United States of America (USA)
97216

More information about ADVOCATES FOR LIFE SKILLS AND OP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01BRETT TURNER2023-04-10 BRETT TURNER2023-04-10
5012020-07-01BRETT TURNER2022-01-27
5012019-07-01BRETT TURNER2021-01-30
5012018-07-01BRETT TURNER2020-04-15
5012017-07-01
5012016-07-01
5012015-07-01
5012014-07-01
5012013-07-01
5012012-07-01ALISON BURT2014-01-28
5012011-07-01ALISON BURT2012-10-23

Plan Statistics for HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR

401k plan membership statisitcs for HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR

Measure Date Value
2021: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2021 401k membership
Total participants, beginning-of-year2021-07-01181
Total number of active participants reported on line 7a of the Form 55002021-07-01124
Total of all active and inactive participants2021-07-01124
2020: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2020 401k membership
Total participants, beginning-of-year2020-07-01191
Number of other retired or separated participants entitled to future benefits2020-07-01181
Total of all active and inactive participants2020-07-01181
2019: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2019 401k membership
Total participants, beginning-of-year2019-07-01162
Total number of active participants reported on line 7a of the Form 55002019-07-01191
Total of all active and inactive participants2019-07-01191
2018: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2018 401k membership
Total participants, beginning-of-year2018-07-01166
Total number of active participants reported on line 7a of the Form 55002018-07-01162
Total of all active and inactive participants2018-07-01162
2017: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2017 401k membership
Total participants, beginning-of-year2017-07-01158
Total number of active participants reported on line 7a of the Form 55002017-07-01166
Total of all active and inactive participants2017-07-01166
2016: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2016 401k membership
Total participants, beginning-of-year2016-07-01163
Total number of active participants reported on line 7a of the Form 55002016-07-01158
Total of all active and inactive participants2016-07-01158
2015: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2015 401k membership
Total participants, beginning-of-year2015-07-01162
Total number of active participants reported on line 7a of the Form 55002015-07-01163
Total of all active and inactive participants2015-07-01163
2014: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2014 401k membership
Total participants, beginning-of-year2014-07-01148
Total number of active participants reported on line 7a of the Form 55002014-07-01162
Total of all active and inactive participants2014-07-01162
2013: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2013 401k membership
Total participants, beginning-of-year2013-07-01141
Total number of active participants reported on line 7a of the Form 55002013-07-01148
Total of all active and inactive participants2013-07-01148

Form 5500 Responses for HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR

2021: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: HEALTH PLAN FOR ADULT LEARNING SYSTEMS OF OR 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5390350
Policy instance 4
Insurance contract or identification number5390350
Number of Individuals Covered106
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberALSOR IMP
Policy instance 3
Insurance contract or identification numberALSOR IMP
Number of Individuals Covered201
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered240
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $21,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered124
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $712,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered181
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $644
Welfare Benefit Premiums Paid to CarrierUSD $1,053,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees644
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered175
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberALSOR IMP
Policy instance 3
Insurance contract or identification numberALSOR IMP
Number of Individuals Covered214
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberOR4
Policy instance 3
Insurance contract or identification numberOR4
Number of Individuals Covered195
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered179
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered191
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $527
Welfare Benefit Premiums Paid to CarrierUSD $919,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees527
Insurance broker organization code?3
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberOR4
Policy instance 3
Insurance contract or identification numberOR4
Number of Individuals Covered138
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered163
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered162
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $40
Welfare Benefit Premiums Paid to CarrierUSD $1,011,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees40
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered161
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered166
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $820
Welfare Benefit Premiums Paid to CarrierUSD $932,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberOR4/Z915
Policy instance 3
Insurance contract or identification numberOR4/Z915
Number of Individuals Covered145
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered163
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $812,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered145
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $95
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $95
Insurance broker organization code?3
Insurance broker nameAKT BENEFIT ADVISORS LP
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberOR4/Z915
Policy instance 3
Insurance contract or identification numberOR4/Z915
Number of Individuals Covered148
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered149
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $224
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $224
Insurance broker organization code?3
Insurance broker nameAKT BENEFIT ADVISORS LP
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered162
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $748
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $753,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees748
Additional information about fees paid to insurance brokerRETENTION BONUS
Insurance broker organization code?3
Insurance broker nameHUGGINS INSURANCE SERVICES INC.
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberZ915/OR4
Policy instance 3
Insurance contract or identification numberZ915/OR4
Number of Individuals Covered151
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHUGGINS INSURANCE SERVICES INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00427512
Policy instance 2
Insurance contract or identification number00427512
Number of Individuals Covered148
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $278
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $278
Insurance broker organization code?3
Insurance broker nameAKT BENEFIT ADVISORS LP
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number17183
Policy instance 1
Insurance contract or identification number17183
Number of Individuals Covered148
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $729
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $713,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees729
Additional information about fees paid to insurance brokerRETENTION BONUS
Insurance broker organization code?3
Insurance broker nameHUGGINS INSURANCE SERVICES INC.
WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 )
Policy contract numberZ915/OR4
Policy instance 3
Insurance contract or identification numberZ915/OR4
Number of Individuals Covered148
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameHUGGINS INSURANCE SERVICES INC.

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