CENTRAL ATLANTIC TOYOTA DISTRIBUTOR has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP INSURANCE MEDICAL DENTAL PLAN
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 4 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 294 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,848,415 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00001406 |
Policy instance | 1 |
Insurance contract or identification number | 00001406 | Number of Individuals Covered | 543 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $3,683,353 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | H56948 |
Policy instance | 2 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 216 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,058,325 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00017516 |
Policy instance | 3 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 432 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $6,772,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 10002401 |
Policy instance | 5 |
Insurance contract or identification number | 10002401 | Number of Individuals Covered | 57 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $312,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 6 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 415 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $7,670,236 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 7 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 58 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,067,683 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 8 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 115 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $663,860 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 9 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 40 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $265,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 15 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 10351 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $5,406,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0800432-SL |
Policy instance | 14 |
Insurance contract or identification number | 0800432-SL | Number of Individuals Covered | 5520 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | STOP LOSS | Welfare Benefit Premiums Paid to Carrier | USD $131,485 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 13 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 180 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $650,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 12 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 525 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $7,760,026 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560-0000 |
Policy instance | 11 |
Insurance contract or identification number | 102560-0000 | Number of Individuals Covered | 2248 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $10,251,322 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 10 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 330 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,504,921 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00748A |
Policy instance | 16 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 33 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $703,719 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 9 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 137 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $580 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $631,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 580 | Additional information about fees paid to insurance broker | RETENTION BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC OF LA |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 8 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 62 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $812,559 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 7 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 421 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-01-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,988,874 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00748A |
Policy instance | 4 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 29 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $671,107 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 5 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 328 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,772,005 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00017516 |
Policy instance | 3 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 405 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,986,984 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H56948 |
Policy instance | 2 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 237 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,125,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 10002401 |
Policy instance | 6 |
Insurance contract or identification number | 10002401 | Number of Individuals Covered | 65 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $283,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 10 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 41 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $227,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560 |
Policy instance | 11 |
Insurance contract or identification number | 102560 | Number of Individuals Covered | 2300 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $9,554,770 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 66927 |
Policy instance | 18 |
Insurance contract or identification number | 66927 | Number of Individuals Covered | 508 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health 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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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0800432-SL |
Policy instance | 17 |
Insurance contract or identification number | 0800432-SL | Number of Individuals Covered | 6317 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | STOP LOSS | Welfare Benefit Premiums Paid to Carrier | USD $2,925,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 16 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 10165 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,333,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 15 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 189 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $48,204 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $595,342 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,558 | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS ADM LLC |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 143179 |
Policy instance | 14 |
Insurance contract or identification number | 143179 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $5,643 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 13 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 575 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $9,024,485 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 12 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 332 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,358,943 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00001406 |
Policy instance | 1 |
Insurance contract or identification number | 00001406 | Number of Individuals Covered | 533 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,598,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 15 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 184 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $41,204 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $553,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,204 | Insurance broker organization code? | 3 | Insurance broker name | MARSH FINANCIAL SERVICES |
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CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 66927 |
Policy instance | 19 |
Insurance contract or identification number | 66927 | Number of Individuals Covered | 269 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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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ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00083759 |
Policy instance | 18 |
Insurance contract or identification number | 00083759 | Number of Individuals Covered | 48 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,020,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 17 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 6409 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | INDIVIDUAL & AGGREGATE EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $3,476,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 16 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 10128 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,464,416 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 143179 |
Policy instance | 14 |
Insurance contract or identification number | 143179 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $10,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 13 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 609 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $7,407,320 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 12 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 319 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,269,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560 |
Policy instance | 11 |
Insurance contract or identification number | 102560 | Number of Individuals Covered | 2231 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $9,173,368 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 9 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 137 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $550 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $521,345 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 550 | Additional information about fees paid to insurance broker | RETENTION BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC OF LA |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 8 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 57 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $816,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 7 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 424 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,889,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00001406 |
Policy instance | 1 |
Insurance contract or identification number | 00001406 | Number of Individuals Covered | 504 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,865,621 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H56948 |
Policy instance | 2 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 229 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,097,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00017516 |
Policy instance | 3 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 397 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,504,573 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00748A |
Policy instance | 4 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 24 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $459,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 5 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 308 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,736,861 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 10002401 |
Policy instance | 6 |
Insurance contract or identification number | 10002401 | Number of Individuals Covered | 50 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $187,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 10 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 38 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $235,868 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 13 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 314 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,094,063 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 17 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 173 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $41,584 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $527,022 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,584 | Insurance broker organization code? | 3 | Insurance broker name | MARSH FINANCIAL SERVICES |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 800432 |
Policy instance | 1 |
Insurance contract or identification number | 800432 | Number of Individuals Covered | 298 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 18 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 9921 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,227,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 19 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 6431 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Other welfare benefits provided | INDIVIDUAL & AGGREGATE EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $3,160,121 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00083759 |
Policy instance | 20 |
Insurance contract or identification number | 00083759 | Number of Individuals Covered | 49 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $938,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 143179 |
Policy instance | 16 |
Insurance contract or identification number | 143179 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $9,627 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 15 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 656 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $7,635,747 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560 |
Policy instance | 14 |
Insurance contract or identification number | 102560 | Number of Individuals Covered | 2170 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $7,401,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 12 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 40 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $240,584 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 11 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 129 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-01-31 | Total amount of fees paid to insurance company | USD $548 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $519,039 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 548 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | MERCER HEALTH & BENEFITS LLC OF LA |
|
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 10 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 67 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $828,903 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 9 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 423 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,310,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00001406 |
Policy instance | 2 |
Insurance contract or identification number | 00001406 | Number of Individuals Covered | 173 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,726,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H56948 |
Policy instance | 3 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 236 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,104,461 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00017516 |
Policy instance | 4 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 392 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,066,202 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 00748A |
Policy instance | 5 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 17 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $271,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 66927 |
Policy instance | 6 |
Insurance contract or identification number | 66927 | Number of Individuals Covered | 248 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | 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 |
|
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 7 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 268 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,511,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 1-93224AA |
Policy instance | 8 |
Insurance contract or identification number | 1-93224AA | Number of Individuals Covered | 55 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $206,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 9 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 284 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,649,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
Policy contract number | 7J81 |
Policy instance | 8 |
Insurance contract or identification number | 7J81 | Number of Individuals Covered | 254 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 00748A |
Policy instance | 7 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 14 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $282,638 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTHCARE OF NJ (National Association of Insurance Commissioners NAIC id number: 95500 ) |
Policy contract number | 3170600 |
Policy instance | 6 |
Insurance contract or identification number | 3170600 | Number of Individuals Covered | 92 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $1,486 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,526,903 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTHCARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3170600 |
Policy instance | 5 |
Insurance contract or identification number | 3170600 | Number of Individuals Covered | 276 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,796,681 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00017516 |
Policy instance | 4 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 372 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,714,422 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H56948 |
Policy instance | 3 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 255 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $1,094,649 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 000007017 |
Policy instance | 2 |
Insurance contract or identification number | 000007017 | Number of Individuals Covered | 224 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,219,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 1-93224AA |
Policy instance | 10 |
Insurance contract or identification number | 1-93224AA | Number of Individuals Covered | 58 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $228,538 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 12 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 62 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $801,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 20 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 6201 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $1,915,175 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 19 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 165 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $39,703 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $494,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 143179 |
Policy instance | 18 |
Insurance contract or identification number | 143179 | Number of Individuals Covered | 86 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $66,737 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 17 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 586 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $7,836,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560 |
Policy instance | 16 |
Insurance contract or identification number | 102560 | Number of Individuals Covered | 759 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | HEALTH CARE SERVICE PLAN | Welfare Benefit Premiums Paid to Carrier | USD $7,926,349 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 15 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 118 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Other welfare benefits provided | HEALTH CARE SERVICE PLAN | Welfare Benefit Premiums Paid to Carrier | USD $1,326,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 14 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 17 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $217,881 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 13 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 41 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $557 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $424,796 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 800432 |
Policy instance | 1 |
Insurance contract or identification number | 800432 | Number of Individuals Covered | 252 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 11 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 424 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,346,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 21 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 11778 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,741,681 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 ) |
Policy contract number | 50158 |
Policy instance | 20 |
Insurance contract or identification number | 50158 | Number of Individuals Covered | 168 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $36,939 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $458,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 7J81 |
Policy instance | 9 |
Insurance contract or identification number | 7J81 | Number of Individuals Covered | 227 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $3,032,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 00748A |
Policy instance | 8 |
Insurance contract or identification number | 00748A | Number of Individuals Covered | 18 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $294,523 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTHCARE OF NJ (National Association of Insurance Commissioners NAIC id number: 95500 ) |
Policy contract number | 3170600 |
Policy instance | 7 |
Insurance contract or identification number | 3170600 | Number of Individuals Covered | 98 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,422,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTHCARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3170600 |
Policy instance | 6 |
Insurance contract or identification number | 3170600 | Number of Individuals Covered | 292 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $3,297,753 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 ) |
Policy contract number | 00017516 |
Policy instance | 5 |
Insurance contract or identification number | 00017516 | Number of Individuals Covered | 361 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $4,093,921 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | H56948 |
Policy instance | 4 |
Insurance contract or identification number | H56948 | Number of Individuals Covered | 256 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $999,946 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) |
Policy contract number | 00001406 |
Policy instance | 2 |
Insurance contract or identification number | 00001406 | Number of Individuals Covered | 171 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $2,140,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 800432 |
Policy instance | 1 |
Insurance contract or identification number | 800432 | Number of Individuals Covered | 237 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | 00083759 |
Policy instance | 3 |
Insurance contract or identification number | 00083759 | Number of Individuals Covered | 54 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $814,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 061207 |
Policy instance | 10 |
Insurance contract or identification number | 061207 | Number of Individuals Covered | 286 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,379,141 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH ALLIANCE PLAN (National Association of Insurance Commissioners NAIC id number: 95844 ) |
Policy contract number | 1-93224AA |
Policy instance | 11 |
Insurance contract or identification number | 1-93224AA | Number of Individuals Covered | 51 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $158,434 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 21 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 5784 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | INDIVIDUAL EXCESS RISK | Welfare Benefit Premiums Paid to Carrier | USD $1,505,584 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 31907-4 |
Policy instance | 22 |
Insurance contract or identification number | 31907-4 | Number of Individuals Covered | 11735 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $4,582,983 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 143179 |
Policy instance | 19 |
Insurance contract or identification number | 143179 | Number of Individuals Covered | 15 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $121,497 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 002402 |
Policy instance | 18 |
Insurance contract or identification number | 002402 | Number of Individuals Covered | 382 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $6,224,945 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102560 |
Policy instance | 17 |
Insurance contract or identification number | 102560 | Number of Individuals Covered | 727 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | HEALTH CARE SERVICE PLAN | Welfare Benefit Premiums Paid to Carrier | USD $6,780,635 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 7840 |
Policy instance | 16 |
Insurance contract or identification number | 7840 | Number of Individuals Covered | 126 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | HEALTH CARE SERVICE PLAN | Welfare Benefit Premiums Paid to Carrier | USD $1,359,913 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1913 |
Policy instance | 14 |
Insurance contract or identification number | 1913 | Number of Individuals Covered | 44 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $467,246 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
Policy contract number | N2189 |
Policy instance | 13 |
Insurance contract or identification number | N2189 | Number of Individuals Covered | 60 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $863,314 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) |
Policy contract number | 750655 |
Policy instance | 12 |
Insurance contract or identification number | 750655 | Number of Individuals Covered | 439 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $6,162,123 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 ) |
Policy contract number | 00395 |
Policy instance | 15 |
Insurance contract or identification number | 00395 | Number of Individuals Covered | 19 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $197,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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