RAMOS OIL COMPANY, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN
401k plan membership statisitcs for RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 215 |
| Total of all active and inactive participants | 2022-04-01 | 215 |
| Total participants | 2022-04-01 | 215 |
| 2021: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-04-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 148 |
| Total of all active and inactive participants | 2021-04-01 | 148 |
| Total participants | 2021-04-01 | 148 |
| 2020: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 159 |
| Total of all active and inactive participants | 2020-04-01 | 159 |
| Total participants | 2020-04-01 | 159 |
| 2019: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 223 |
| Total of all active and inactive participants | 2019-04-01 | 223 |
| Total participants | 2019-04-01 | 223 |
| 2018: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 147 |
| Total of all active and inactive participants | 2018-04-01 | 147 |
| Total participants | 2018-04-01 | 147 |
| 2017: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 147 |
| Total of all active and inactive participants | 2017-04-01 | 147 |
| Total participants | 2017-04-01 | 147 |
| 2016: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 129 |
| Total of all active and inactive participants | 2016-04-01 | 129 |
| Total participants | 2016-04-01 | 129 |
| 2015: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 134 |
| Total of all active and inactive participants | 2015-04-01 | 134 |
| Total participants | 2015-04-01 | 0 |
| 2014: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 127 |
| Total of all active and inactive participants | 2014-04-01 | 127 |
| Total participants | 2014-04-01 | 0 |
| 2013: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 137 |
| Total of all active and inactive participants | 2013-04-01 | 137 |
| Total participants | 2013-04-01 | 0 |
| 2012: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 122 |
| Total of all active and inactive participants | 2012-04-01 | 122 |
| Total participants | 2012-04-01 | 0 |
| 2011: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 138 |
| Total of all active and inactive participants | 2011-04-01 | 138 |
| Total participants | 2011-04-01 | 138 |
| 2022: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: RAMOS OIL COMPANY, INC. EMPLOYEE HEALTH PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | First time form 5500 has been submitted | Yes |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | 704736 |
| Policy instance | 5 |
| Insurance contract or identification number | 704736 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $23,736 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $133,751 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,681 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 704734 |
| Policy instance | 4 |
| Insurance contract or identification number | 704734 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $9,364 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $49,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,561 | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 605647 |
| Policy instance | 3 |
| Insurance contract or identification number | 605647 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $20,841 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $527,430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,841 | | Insurance broker organization code? | 3 |
|
| SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 ) |
| Policy contract number | 220010 |
| Policy instance | 2 |
| Insurance contract or identification number | 220010 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $24,342 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $442,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,342 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 1 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $20,701 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $414,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,701 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 1 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,327 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,327 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 2 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $19,929 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $399,888 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,929 | | Insurance broker organization code? | 3 |
|
| SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 ) |
| Policy contract number | 220010 |
| Policy instance | 3 |
| Insurance contract or identification number | 220010 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $25,751 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $468,195 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,751 | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 605647 |
| Policy instance | 4 |
| Insurance contract or identification number | 605647 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $22,343 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $488,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,343 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 704734 |
| Policy instance | 5 |
| Insurance contract or identification number | 704734 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $4,168 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $22,536 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,680 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 704735 |
| Policy instance | 6 |
| Insurance contract or identification number | 704735 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $2,799 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $14,162 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,834 | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | 704736 |
| Policy instance | 7 |
| Insurance contract or identification number | 704736 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $5,833 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,102 | | Insurance broker organization code? | 3 |
|
| SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 ) |
| Policy contract number | 220010 |
| Policy instance | 3 |
| Insurance contract or identification number | 220010 | | Number of Individuals Covered | 87 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $25,523 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $464,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,523 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 1 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $11,567 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $166,995 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,567 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 2 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $21,441 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $428,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,441 | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 605647 |
| Policy instance | 5 |
| Insurance contract or identification number | 605647 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $14,320 | | Total amount of fees paid to insurance company | USD $283 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $322,830 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,320 | | Amount paid for insurance broker fees | 283 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | P108014 |
| Policy instance | 4 |
| Insurance contract or identification number | P108014 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $5,462 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,231 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,462 | | Insurance broker organization code? | 3 |
|
| SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 ) |
| Policy contract number | 220010 |
| Policy instance | 3 |
| Insurance contract or identification number | 220010 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $23,745 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $431,722 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,745 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 2 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $23,729 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $474,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,729 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 1 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $13,731 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $179,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,731 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | P108014 |
| Policy instance | 4 |
| Insurance contract or identification number | P108014 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $6,131 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $154,787 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,131 | | Insurance broker organization code? | 3 |
|
| SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 ) |
| Policy contract number | 220010 |
| Policy instance | 3 |
| Insurance contract or identification number | 220010 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $21,068 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $383,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,068 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 2 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $24,451 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $490,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,451 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 1 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $15,220 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $180,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,220 | | Insurance broker organization code? | 3 |
|
| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 108014 |
| Policy instance | 3 |
| Insurance contract or identification number | 108014 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $10,400 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $208,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,400 | | Insurance broker organization code? | 3 | | Insurance broker name | CSR LINK INSURANCE SERVICES |
|
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 131 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $20,107 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $416,721 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,107 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 1 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $11,253 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $137,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,253 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 278070 |
| Policy instance | 1 |
| Insurance contract or identification number | 278070 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $38,187 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $884,269 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,187 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 2 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $8,048 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,048 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00480099 |
| Policy instance | 2 |
| Insurance contract or identification number | 00480099 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $7,315 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,115 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,315 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 278070 |
| Policy instance | 1 |
| Insurance contract or identification number | 278070 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $36,106 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $830,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,106 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 278070 |
| Policy instance | 2 |
| Insurance contract or identification number | 278070 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $17,592 | | Total amount of fees paid to insurance company | USD $3,225 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $576,978 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,592 | | Amount paid for insurance broker fees | 3225 | | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, COMMUNICATIONS & TRAINING | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0752214 |
| Policy instance | 1 |
| Insurance contract or identification number | 0752214 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $15,142 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $242,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,142 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0752214 |
| Policy instance | 2 |
| Insurance contract or identification number | 0752214 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $21,121 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $482,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,121 | | Insurance broker organization code? | 3 | | Insurance broker name | STEVEN M. LEBEDOFF |
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| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 105986 |
| Policy instance | 1 |
| Insurance contract or identification number | 105986 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2012-08-30 | | Total amount of commissions paid to insurance broker | USD $11,283 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $225,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,283 | | Insurance broker organization code? | 3 | | Insurance broker name | CSR LINK INSURANCE SERVICES |
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| WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 ) |
| Policy contract number | 105986 |
| Policy instance | 1 |
| Insurance contract or identification number | 105986 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $17,000 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $340,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 166386 |
| Policy instance | 2 |
| Insurance contract or identification number | 166386 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $15,645 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $313,915 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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