ED STAUB & SONS PETROLEUM, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN
401k plan membership statisitcs for ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN
Measure | Date | Value |
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2022: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 649 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 612 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 612 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 559 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 649 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 649 |
Number of employers contributing to the scheme | 2021-01-01 | 0 |
2020: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 533 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 533 |
Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
Total of all active and inactive participants | 2020-05-01 | 533 |
Number of employers contributing to the scheme | 2020-05-01 | 0 |
2019: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-05-01 | 452 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 533 |
Number of retired or separated participants receiving benefits | 2019-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 0 |
Total of all active and inactive participants | 2019-05-01 | 533 |
Number of employers contributing to the scheme | 2019-05-01 | 0 |
2018: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-05-01 | 407 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 452 |
Number of retired or separated participants receiving benefits | 2018-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
Total of all active and inactive participants | 2018-05-01 | 452 |
Number of employers contributing to the scheme | 2018-05-01 | 0 |
2017: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 269 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 407 |
Number of retired or separated participants receiving benefits | 2017-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 0 |
Total of all active and inactive participants | 2017-05-01 | 407 |
2016: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 242 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 337 |
Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
Total of all active and inactive participants | 2016-05-01 | 337 |
2015: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 196 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 242 |
Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
Total of all active and inactive participants | 2015-05-01 | 242 |
2014: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 196 |
Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
Total of all active and inactive participants | 2014-05-01 | 196 |
2013: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 189 |
Total of all active and inactive participants | 2013-05-01 | 189 |
2012: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 124 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 159 |
Total of all active and inactive participants | 2012-05-01 | 159 |
2011: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 124 |
Total of all active and inactive participants | 2011-05-01 | 124 |
2009: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 122 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 114 |
Total of all active and inactive participants | 2009-05-01 | 114 |
2022: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Submission has been amended | Yes |
2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2019 form 5500 responses |
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2019-05-01 | Type of plan entity | Single employer plan |
2019-05-01 | Plan funding arrangement – Insurance | Yes |
2019-05-01 | Plan benefit arrangement – Insurance | Yes |
2018: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2018 form 5500 responses |
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2018-05-01 | Type of plan entity | Single employer plan |
2018-05-01 | Plan funding arrangement – Insurance | Yes |
2018-05-01 | Plan benefit arrangement – Insurance | Yes |
2017: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2016: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2015: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2014: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2013: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2013 form 5500 responses |
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2013-05-01 | Type of plan entity | Single employer plan |
2013-05-01 | Plan funding arrangement – Insurance | Yes |
2013-05-01 | Plan benefit arrangement – Insurance | Yes |
2012: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2012 form 5500 responses |
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2012-05-01 | Type of plan entity | Single employer plan |
2012-05-01 | Plan funding arrangement – Insurance | Yes |
2012-05-01 | Plan benefit arrangement – Insurance | Yes |
2011: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2011 form 5500 responses |
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2011-05-01 | Type of plan entity | Single employer plan |
2011-05-01 | Plan funding arrangement – Insurance | Yes |
2011-05-01 | Plan benefit arrangement – Insurance | Yes |
2009: ED STAUB & SONS PETROLEUM, INC. 125 CAFETERIA PLAN 2009 form 5500 responses |
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2009-05-01 | Type of plan entity | Single employer plan |
2009-05-01 | This submission is the final filing | No |
2009-05-01 | Plan funding arrangement – Insurance | Yes |
2009-05-01 | Plan benefit arrangement – Insurance | Yes |
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 930428 |
Policy instance | 2 |
Insurance contract or identification number | 930428 | Number of Individuals Covered | 471 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $4,779 | Total amount of fees paid to insurance company | USD $2,824 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $199,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,779 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017979-00 |
Policy instance | 1 |
Insurance contract or identification number | 01-017979-00 | Number of Individuals Covered | 471 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $25,838 | Total amount of fees paid to insurance company | USD $11,974 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $258,377 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $25,838 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 11974 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 930428 |
Policy instance | 2 |
Insurance contract or identification number | 930428 | Number of Individuals Covered | 447 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,854 | Total amount of fees paid to insurance company | USD $1,635 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,209 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,854 | Amount paid for insurance broker fees | 1635 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017979-00 |
Policy instance | 1 |
Insurance contract or identification number | 01-017979-00 | Number of Individuals Covered | 649 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $18,286 | Total amount of fees paid to insurance company | USD $7,167 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $182,859 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,286 | Amount paid for insurance broker fees | 7167 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 ) |
Policy contract number | G0037000 |
Policy instance | 1 |
Insurance contract or identification number | G0037000 | Number of Individuals Covered | 533 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,932 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017979-00 |
Policy instance | 2 |
Insurance contract or identification number | 01-017979-00 | Number of Individuals Covered | 533 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $121,226 | Commission paid to Insurance Broker | USD $12,123 | Amount paid for insurance broker fees | 5706 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 930428 |
Policy instance | 3 |
Insurance contract or identification number | 930428 | Number of Individuals Covered | 307 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,497 | Total amount of fees paid to insurance company | USD $1,779 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,497 | Amount paid for insurance broker fees | 1779 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 930428 |
Policy instance | 3 |
Insurance contract or identification number | 930428 | Number of Individuals Covered | 280 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $4,227 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $143,996 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,227 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017979-00 |
Policy instance | 2 |
Insurance contract or identification number | 01-017979-00 | Number of Individuals Covered | 533 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $14,909 | Total amount of fees paid to insurance company | USD $6,748 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $149,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,909 | Amount paid for insurance broker fees | 6748 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 ) |
Policy contract number | G0037000 |
Policy instance | 1 |
Insurance contract or identification number | G0037000 | Number of Individuals Covered | 291 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $99,035 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,980,694 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $99,035 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 1D03235400000 |
Policy instance | 2 |
Insurance contract or identification number | 1D03235400000 | Number of Individuals Covered | 407 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $13,456 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $224,135 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,813 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | HECHT AND HECHT LIFE AND HEALTH INS |
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PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 ) |
Policy contract number | G0037000 |
Policy instance | 1 |
Insurance contract or identification number | G0037000 | Number of Individuals Covered | 261 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $76,714 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,703 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | HECHT AND HECHT LIFE AND HEALTH INS |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 239 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $99,860 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $99,860 | Insurance broker organization code? | 3 | Insurance broker name | HECHT & HECHT LIFE & INS AGENCY |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50017630 |
Policy instance | 2 |
Insurance contract or identification number | 50017630 | Number of Individuals Covered | 242 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $1,841 | Life Insurance Welfare Benefit | Yes | Temporary Disability 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 $943 | Insurance broker organization code? | 3 | Insurance broker name | CONNEXION INSURANCE AGENGY INC |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50017630 |
Policy instance | 3 |
Insurance contract or identification number | 50017630 | Number of Individuals Covered | 187 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $5,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,637 | Insurance broker organization code? | 3 | Insurance broker name | CONNEXION INSURANCE AGENGY INC |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 159 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $78,313 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $78,313 | Insurance broker organization code? | 3 | Insurance broker name | HECHT & HECHT LIFE & INS AGENCY |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 159 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker name | HECHT & HECHT LIFE & INS AGENCY |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 159 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $59,352 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $59,352 | Insurance broker name | HECHT & HECHT LIFE & INS AGENCY |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 124 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $42,059 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 ) |
Policy contract number | 1030515 |
Policy instance | 1 |
Insurance contract or identification number | 1030515 | Number of Individuals Covered | 127 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $24,260 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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