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PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NamePATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

PATRICK K. WILLIS COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:PATRICK K. WILLIS COMPANY, INC.
Employer identification number (EIN):943394523
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01ERIN SARVARIAN2023-10-04
5012021-04-01ERIN SARVARIAN2022-10-28
5012020-04-01ERIN SARVARIAN2021-10-01
5012019-04-01ERIN SARVARIAN2020-07-29
5012018-04-01ERIN SARVARIAN2019-10-03
5012017-04-01
5012016-04-01ERIN SARVARIAN
5012015-04-01DAVID COPELAND
5012014-04-01DAVE COPELAND
5012013-04-01DAVE COPELAND
5012012-04-01C. D. COPELAND
5012011-04-01DAVID COPELAND
5012009-04-01DAVID COPELAND

Plan Statistics for PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2022: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01326
Total number of active participants reported on line 7a of the Form 55002022-04-01346
Number of retired or separated participants receiving benefits2022-04-012
Number of other retired or separated participants entitled to future benefits2022-04-015
Total of all active and inactive participants2022-04-01353
Number of employers contributing to the scheme2022-04-010
2021: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01258
Total number of active participants reported on line 7a of the Form 55002021-04-01260
Number of retired or separated participants receiving benefits2021-04-011
Number of other retired or separated participants entitled to future benefits2021-04-0119
Total of all active and inactive participants2021-04-01280
Number of employers contributing to the scheme2021-04-010
2020: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01313
Total number of active participants reported on line 7a of the Form 55002020-04-01296
Number of retired or separated participants receiving benefits2020-04-012
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01298
Number of employers contributing to the scheme2020-04-010
2019: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01331
Total number of active participants reported on line 7a of the Form 55002019-04-01313
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01313
Number of employers contributing to the scheme2019-04-010
2018: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01295
Total number of active participants reported on line 7a of the Form 55002018-04-01331
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01331
Number of employers contributing to the scheme2018-04-010
2017: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01281
Total number of active participants reported on line 7a of the Form 55002017-04-01295
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01295
2016: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01246
Total number of active participants reported on line 7a of the Form 55002016-04-01281
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01281
2015: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01215
Total number of active participants reported on line 7a of the Form 55002015-04-01246
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01246
2014: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01175
Total number of active participants reported on line 7a of the Form 55002014-04-01215
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01215
2013: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01158
Total number of active participants reported on line 7a of the Form 55002013-04-01175
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01175
2012: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01195
Total number of active participants reported on line 7a of the Form 55002012-04-01156
Number of retired or separated participants receiving benefits2012-04-012
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01158
2011: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01202
Total number of active participants reported on line 7a of the Form 55002011-04-01192
Number of retired or separated participants receiving benefits2011-04-013
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-01195
2009: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01145
Total number of active participants reported on line 7a of the Form 55002009-04-01198
Number of retired or separated participants receiving benefits2009-04-013
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01201

Form 5500 Responses for PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN

2022: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2009: PATRICK K. WILLIS COMPANY, INC. HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01First time form 5500 has been submittedYes
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SAINT MARYS HEALTHFIRST (National Association of Insurance Commissioners NAIC id number: 11079 )
Policy contract numberGRP0006769
Policy instance 5
Insurance contract or identification numberGRP0006769
Number of Individuals Covered44
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $5,160
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $138,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,160
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 4
Insurance contract or identification number440161
Number of Individuals Covered346
Insurance policy start date2022-04-01
Insurance policy end date2023-03-30
Total amount of commissions paid to insurance brokerUSD $37,499
Total amount of fees paid to insurance companyUSD $10,012
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $344,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,499
Amount paid for insurance broker fees10012
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 3
Insurance contract or identification number100786
Number of Individuals Covered115
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $42,416
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $706,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,416
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 2
Insurance contract or identification number51633
Number of Individuals Covered205
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $63,800
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,372,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63,800
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered52
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $16,923
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $338,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,923
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered49
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $18,306
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $366,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,306
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 2
Insurance contract or identification number51633
Number of Individuals Covered137
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $67,241
Total amount of fees paid to insurance companyUSD $2,785
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,371,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67,241
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 3
Insurance contract or identification number100786
Number of Individuals Covered118
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $45,954
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $768,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,954
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 4
Insurance contract or identification number440161
Number of Individuals Covered260
Insurance policy start date2021-04-01
Insurance policy end date2022-03-30
Total amount of commissions paid to insurance brokerUSD $28,367
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $262,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,367
Amount paid for insurance broker fees0
Insurance broker organization code?3
SAINT MARYS HEALTHFIRST (National Association of Insurance Commissioners NAIC id number: 11079 )
Policy contract numberGRP0006769
Policy instance 5
Insurance contract or identification numberGRP0006769
Number of Individuals Covered15
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $2,307
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,307
Amount paid for insurance broker fees0
Insurance broker organization code?3
SAINT MARYS HEALTHFIRST (National Association of Insurance Commissioners NAIC id number: 11079 )
Policy contract numberGRP0006769
Policy instance 6
Insurance contract or identification numberGRP0006769
Number of Individuals Covered2
Insurance policy start date2022-02-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $596
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $596
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 5
Insurance contract or identification number440161
Number of Individuals Covered296
Insurance policy start date2020-04-01
Insurance policy end date2021-03-30
Total amount of commissions paid to insurance brokerUSD $36,759
Total amount of fees paid to insurance companyUSD $9,737
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $346,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,759
Amount paid for insurance broker fees9737
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 4
Insurance contract or identification number100786
Number of Individuals Covered156
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $49,290
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $907,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,290
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 3
Insurance contract or identification number51633
Number of Individuals Covered242
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $71,483
Total amount of fees paid to insurance companyUSD $33
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,446,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,483
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract numberP100786/TD329
Policy instance 2
Insurance contract or identification numberP100786/TD329
Number of Individuals Covered1
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,537
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,537
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered63
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $19,844
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $396,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,844
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 3
Insurance contract or identification number51633
Number of Individuals Covered263
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $70,676
Total amount of fees paid to insurance companyUSD $2,131
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,418,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,676
Insurance broker organization code?3
Amount paid for insurance broker fees2131
Additional information about fees paid to insurance brokerBONUS
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered65
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $18,735
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $374,695
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,735
Amount paid for insurance broker fees0
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract numberP100786 & TD329
Policy instance 2
Insurance contract or identification numberP100786 & TD329
Number of Individuals Covered2
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $1,334
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,334
Amount paid for insurance broker fees0
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 4
Insurance contract or identification number100786
Number of Individuals Covered160
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $47,741
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $861,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,741
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 5
Insurance contract or identification number440161
Number of Individuals Covered313
Insurance policy start date2019-04-01
Insurance policy end date2020-03-30
Total amount of commissions paid to insurance brokerUSD $36,492
Total amount of fees paid to insurance companyUSD $10,414
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $349,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,492
Amount paid for insurance broker fees10414
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 5
Insurance contract or identification number440161
Number of Individuals Covered331
Insurance policy start date2018-04-01
Insurance policy end date2019-03-30
Total amount of commissions paid to insurance brokerUSD $32,976
Total amount of fees paid to insurance companyUSD $2,093
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $315,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,106
Amount paid for insurance broker fees2093
Insurance broker organization code?3
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered65
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $14,564
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $291,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,199
Amount paid for insurance broker fees0
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract numberP100786 &TD329
Policy instance 2
Insurance contract or identification numberP100786 &TD329
Number of Individuals Covered2
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $1,202
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $636
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 3
Insurance contract or identification number51633
Number of Individuals Covered277
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $70,288
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,407,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,261
Amount paid for insurance broker fees0
Insurance broker organization code?3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 4
Insurance contract or identification number100786
Number of Individuals Covered168
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $48,418
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $806,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,432
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number440161
Policy instance 5
Insurance contract or identification number440161
Number of Individuals Covered295
Insurance policy start date2017-04-01
Insurance policy end date2018-03-30
Total amount of commissions paid to insurance brokerUSD $34,061
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $322,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,061
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract number100786
Policy instance 4
Insurance contract or identification number100786
Number of Individuals Covered169
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $39,301
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $655,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,301
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number51633
Policy instance 3
Insurance contract or identification number51633
Number of Individuals Covered255
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $60,056
Total amount of fees paid to insurance companyUSD $1,069
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,222,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,056
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 6411 )
Policy contract numberP100786 &TD329
Policy instance 2
Insurance contract or identification numberP100786 &TD329
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $512
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $512
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
SUTTER HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15107 )
Policy contract number224602
Policy instance 1
Insurance contract or identification number224602
Number of Individuals Covered53
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $2,140
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,140
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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