SUN-MAID GROWERS OF CALIFORNIA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN)
401k plan membership statisitcs for SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN)
| Measure | Date | Value |
|---|
| 2022: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 389 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 376 |
| Total of all active and inactive participants | 2022-01-01 | 376 |
| Total participants | 2022-01-01 | 376 |
| 2021: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 412 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 387 |
| Total of all active and inactive participants | 2021-01-01 | 387 |
| Total participants | 2021-01-01 | 387 |
| 2020: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 433 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 413 |
| Total of all active and inactive participants | 2020-01-01 | 413 |
| Total participants | 2020-01-01 | 413 |
| 2019: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 482 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 436 |
| Total of all active and inactive participants | 2019-01-01 | 436 |
| Total participants | 2019-01-01 | 436 |
| 2018: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 521 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 473 |
| Total of all active and inactive participants | 2018-01-01 | 473 |
| Total participants | 2018-01-01 | 473 |
| 2017: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 562 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 514 |
| Total of all active and inactive participants | 2017-01-01 | 514 |
| Total participants | 2017-01-01 | 514 |
| 2016: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 536 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 541 |
| Total of all active and inactive participants | 2016-01-01 | 541 |
| Total participants | 2016-01-01 | 541 |
| 2015: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 520 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 532 |
| Total of all active and inactive participants | 2015-01-01 | 532 |
| Total participants | 2015-01-01 | 0 |
| 2014: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 525 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 519 |
| Total of all active and inactive participants | 2014-01-01 | 519 |
| Total participants | 2014-01-01 | 0 |
| 2013: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 534 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 527 |
| Total of all active and inactive participants | 2013-01-01 | 527 |
| Total participants | 2013-01-01 | 0 |
| 2012: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 524 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 524 |
| Total of all active and inactive participants | 2012-01-01 | 524 |
| Total participants | 2012-01-01 | 0 |
| 2010: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 509 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 494 |
| Total of all active and inactive participants | 2010-01-01 | 494 |
| Total participants | 2010-01-01 | 494 |
| 2009: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 514 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 464 |
| Total of all active and inactive participants | 2009-10-01 | 464 |
| Total participants | 2009-10-01 | 464 |
| Measure | Date | Value |
|---|
| 2021 : SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2021 401k financial data |
|---|
| Value of total assets at end of year | 2021-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Was this plan covered by a fidelity bond | 2021-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2021-12-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-12-31 | No |
| Did the plan have assets held for investment | 2021-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| 2020 : SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2020 401k financial data |
|---|
| Value of total assets at end of year | 2020-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Was this plan covered by a fidelity bond | 2020-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2020-12-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-12-31 | No |
| Did the plan have assets held for investment | 2020-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| 2019 : SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2019 401k financial data |
|---|
| Value of total assets at end of year | 2019-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest in pooled separate accounts at end of year | 2019-12-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-12-31 | No |
| Did the plan have assets held for investment | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| 2022: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan is a collectively bargained plan | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan is a collectively bargained plan | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan is a collectively bargained plan | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan is a collectively bargained plan | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan is a collectively bargained plan | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan is a collectively bargained plan | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan is a collectively bargained plan | Yes |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan is a collectively bargained plan | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan is a collectively bargained plan | Yes |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SUN-MAID GROWERS OF CALIFORNIA (TEAMSTERS HEALTH PLAN) 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2009-10-01 | Plan is a collectively bargained plan | Yes |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | SL1107 |
| Policy instance | 4 |
| Insurance contract or identification number | SL1107 | | Number of Individuals Covered | 330 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $89,871 | | Welfare Benefit Premiums Paid to Carrier | USD $718,350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $89,871 | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $8,161 | | Total amount of fees paid to insurance company | USD $187 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,612 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 187 | | Additional information about fees paid to insurance broker | MISC FEE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 336 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 376 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,581 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,448 | | 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: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $9,596 | | Total amount of fees paid to insurance company | USD $110 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,483 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 110 | | Additional information about fees paid to insurance broker | MISC FEE |
|
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | SL1107 |
| Policy instance | 4 |
| Insurance contract or identification number | SL1107 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $87,790 | | Welfare Benefit Premiums Paid to Carrier | USD $702,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $87,790 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 413 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,211 | | 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: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 382 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 379 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,063 | | Total amount of fees paid to insurance company | USD $8 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,388 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,179 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 8 | | Additional information about fees paid to insurance broker | MISC FEE |
|
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | SL1107 |
| Policy instance | 4 |
| Insurance contract or identification number | SL1107 | | Number of Individuals Covered | 378 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $91,573 | | Welfare Benefit Premiums Paid to Carrier | USD $732,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $91,573 | | Insurance broker organization code? | 3 |
|
| AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
| Policy contract number | SL1107 |
| Policy instance | 4 |
| Insurance contract or identification number | SL1107 | | Number of Individuals Covered | 401 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $83,886 | | Welfare Benefit Premiums Paid to Carrier | USD $798,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,515 | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 397 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $9,009 | | Total amount of fees paid to insurance company | USD $608 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,148 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 608 | | Additional information about fees paid to insurance broker | SERVICE FEE |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 397 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 436 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,349 | | 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: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $12,533 | | Total amount of fees paid to insurance company | USD $569 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,162 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 569 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker name | VILLANE WARD INSURANCE SERVICES INC |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GI200509-4 |
| Policy instance | 4 |
| Insurance contract or identification number | GI200509-4 | | Number of Individuals Covered | 498 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $127,341 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66,702 | | Insurance broker organization code? | 3 | | Insurance broker name | XL BENEFIT INSURANCE SERVICES |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 4 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $11,790 | | Total amount of fees paid to insurance company | USD $328 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,023 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,737 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 328 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker name | VILLANE WARD INSURANCE SERVICES INC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 532 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,758 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GI200509-2 |
| Policy instance | 5 |
| Insurance contract or identification number | GI200509-2 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $123,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,786 | | Insurance broker organization code? | 3 | | Insurance broker name | XL BENEFIT INSURANCE SERVICES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 3 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVANTE BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 515 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Other welfare benefits provided | BEHAVIORAL HEALTH | | Welfare Benefit Premiums Paid to Carrier | USD $78,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,990 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVANTE BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 492 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Other welfare benefits provided | BEHAVIORAL HEALTH | | Welfare Benefit Premiums Paid to Carrier | USD $76,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-301357 |
| Policy instance | 4 |
| Insurance contract or identification number | 010-301357 | | Number of Individuals Covered | 507 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $10,748 | | Total amount of fees paid to insurance company | USD $472 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,142 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 472 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker name | VILLANE WARD INSURANCE SERVICES INC |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GER-IND-200509 |
| Policy instance | 5 |
| Insurance contract or identification number | GER-IND-200509 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $102,205 | | Life 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 $76,783 | | Insurance broker organization code? | 3 | | Insurance broker name | XL BENEFIT INSURANCE SERVICES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 3 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 495 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | AFA-IND-300500 |
| Policy instance | 4 |
| Insurance contract or identification number | AFA-IND-300500 | | Number of Individuals Covered | 506 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $104,656 | | Health 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 $63,956 | | Insurance broker organization code? | 3 | | Insurance broker name | STOP LOSS INSURANCE SERVICES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 3 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 505 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVANTE BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 502 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Other welfare benefits provided | BEHAVIORAL HEALTH | | Welfare Benefit Premiums Paid to Carrier | USD $76,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 1 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | IIS 00411-12 |
| Policy instance | 1 |
| Insurance contract or identification number | IIS 00411-12 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $119,096 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $967,842 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,964 | | Insurance broker organization code? | 3 | | Insurance broker name | AHART BENEFIT INSURANCE SERVICE |
|
| AVANTE BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 494 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Other welfare benefits provided | BEHAVIORAL HEALTH | | Welfare Benefit Premiums Paid to Carrier | USD $74,506 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 4 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 538 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,384 | | 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: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 2 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 495 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 044682 |
| Policy instance | 4 |
| Insurance contract or identification number | 044682 | | Number of Individuals Covered | 510 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,443 | | 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: 00000 ) |
| Policy contract number | 00114191 |
| Policy instance | 1 |
| Insurance contract or identification number | 00114191 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVANTE BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 52411 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 465 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Other welfare benefits provided | BEHAVIORAL HEALTH | | Welfare Benefit Premiums Paid to Carrier | USD $71,319 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ADMINISTRATIVE SOLUTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00023 |
| Policy instance | 3 |
| Insurance contract or identification number | 00023 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
