DEWEY SERVICES, INCORPORATED has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC
401k plan membership statisitcs for GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC
| Measure | Date | Value |
|---|
| 2022: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-03-01 | 548 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 537 |
| Total of all active and inactive participants | 2022-03-01 | 537 |
| Total participants | 2022-03-01 | 537 |
| 2021: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-03-01 | 556 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 548 |
| Total of all active and inactive participants | 2021-03-01 | 548 |
| Total participants | 2021-03-01 | 548 |
| 2020: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 626 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 556 |
| Total of all active and inactive participants | 2020-03-01 | 556 |
| Total participants | 2020-03-01 | 556 |
| 2019: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 698 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 626 |
| Total of all active and inactive participants | 2019-03-01 | 626 |
| Total participants | 2019-03-01 | 626 |
| 2018: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 754 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 698 |
| Total of all active and inactive participants | 2018-03-01 | 698 |
| Total participants | 2018-03-01 | 698 |
| 2017: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 453 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 754 |
| Total of all active and inactive participants | 2017-03-01 | 754 |
| Total participants | 2017-03-01 | 754 |
| 2016: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 453 |
| Total of all active and inactive participants | 2016-03-01 | 453 |
| Total participants | 2016-03-01 | 453 |
| 2015: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 457 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 444 |
| Total of all active and inactive participants | 2015-03-01 | 444 |
| Total participants | 2015-03-01 | 0 |
| 2014: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 478 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 457 |
| Total of all active and inactive participants | 2014-03-01 | 457 |
| Total participants | 2014-03-01 | 0 |
| 2013: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 490 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 478 |
| Total of all active and inactive participants | 2013-03-01 | 478 |
| Total participants | 2013-03-01 | 0 |
| 2012: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 475 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 490 |
| Total of all active and inactive participants | 2012-03-01 | 490 |
| Total participants | 2012-03-01 | 0 |
| 2011: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 490 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 475 |
| Total of all active and inactive participants | 2011-03-01 | 475 |
| Total participants | 2011-03-01 | 475 |
| 2010: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 440 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 490 |
| Total of all active and inactive participants | 2010-03-01 | 490 |
| Total participants | 2010-03-01 | 490 |
| 2009: GROUP LIFE AND HEALTH PLAN FOR DEWEY SERVICES, INC 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 472 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 440 |
| Total of all active and inactive participants | 2009-03-01 | 440 |
| Total participants | 2009-03-01 | 440 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 887035G |
| Policy instance | 1 |
| Insurance contract or identification number | 887035G | | Number of Individuals Covered | 537 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $9,824 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $65,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,824 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 282286 |
| Policy instance | 2 |
| Insurance contract or identification number | 282286 | | Number of Individuals Covered | 532 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $161,557 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,118,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $142,081 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 282286 |
| Policy instance | 2 |
| Insurance contract or identification number | 282286 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $154,901 | | Total amount of fees paid to insurance company | USD $1,857 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,678,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $139,855 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1857 | | Additional information about fees paid to insurance broker | BONUS, OVERRIDE AND/OR NON-MONETARY COMPENSATION |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 887035G |
| Policy instance | 1 |
| Insurance contract or identification number | 887035G | | Number of Individuals Covered | 548 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $8,496 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $61,868 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,496 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10108941001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10108941001 | | Number of Individuals Covered | 451 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $4,096 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,175 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,096 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 282286 |
| Policy instance | 3 |
| Insurance contract or identification number | 282286 | | Number of Individuals Covered | 525 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $159,008 | | Total amount of fees paid to insurance company | USD $32,529 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,318,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $147,569 | | Amount paid for insurance broker fees | 32529 | | Additional information about fees paid to insurance broker | BONUS, OVERRIDE AND/OR NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 887035G |
| Policy instance | 2 |
| Insurance contract or identification number | 887035G | | Number of Individuals Covered | 556 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $9,092 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $60,286 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,092 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 887035G |
| Policy instance | 4 |
| Insurance contract or identification number | 887035G | | Number of Individuals Covered | 626 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $8,749 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $53,424 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,749 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10108941001 |
| Policy instance | 3 |
| Insurance contract or identification number | 10108941001 | | Number of Individuals Covered | 445 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $3,386 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,647 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,798 | | Insurance broker organization code? | 3 |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 5942596 |
| Policy instance | 1 |
| Insurance contract or identification number | 5942596 | | Number of Individuals Covered | 459 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $5,700 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,162 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,700 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5942596 |
| Policy instance | 2 |
| Insurance contract or identification number | 5942596 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $6,598 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,598 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 282286 |
| Policy instance | 5 |
| Insurance contract or identification number | 282286 | | Number of Individuals Covered | 551 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $136,362 | | Welfare Benefit Premiums Paid to Carrier | USD $2,930,113 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $136,362 | | Additional information about fees paid to insurance broker | . | | Insurance broker organization code? | 3 |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | KM05942596 |
| Policy instance | 3 |
| Insurance contract or identification number | KM05942596 | | Number of Individuals Covered | 420 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $5,554 | | Total amount of fees paid to insurance company | USD $629 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,238 | | Amount paid for insurance broker fees | 629 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968787 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 968787 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $1,719 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,719 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967276 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX967276 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $5,011 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,011 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05942596 |
| Policy instance | 4 |
| Insurance contract or identification number | KM05942596 | | Number of Individuals Covered | 698 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $10,468 | | Total amount of fees paid to insurance company | USD $1,489 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $106,905 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,124 | | Amount paid for insurance broker fees | 1489 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10108941001 |
| Policy instance | 5 |
| Insurance contract or identification number | 10108941001 | | Number of Individuals Covered | 453 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $3,525 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,525 | | Insurance broker organization code? | 3 |
|
| RIVERSTONE CAPITAL (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | PRM266 |
| Policy instance | 7 |
| Insurance contract or identification number | PRM266 | | Number of Individuals Covered | 436 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $123,241 | | Welfare Benefit Premiums Paid to Carrier | USD $2,245,225 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10108941001 |
| Policy instance | 6 |
| Insurance contract or identification number | 10108941001 | | Number of Individuals Covered | 402 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $2,694 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,694 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES INS SVS |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05942596 |
| Policy instance | 5 |
| Insurance contract or identification number | KM05942596 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $13,079 | | Total amount of fees paid to insurance company | USD $375 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $129,825 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,079 | | Amount paid for insurance broker fees | 375 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES INS SVS |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | KM05942596 |
| Policy instance | 4 |
| Insurance contract or identification number | KM05942596 | | Number of Individuals Covered | 342 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $4,000 | | Total amount of fees paid to insurance company | USD $109 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,740 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,000 | | Amount paid for insurance broker fees | 109 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES INS SVS |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967276 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX967276 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $4,978 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,978 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968787 |
| Policy instance | 2 |
| Insurance contract or identification number | OK 968787 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $1,514 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,514 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INC |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 1 |
| Insurance contract or identification number | 165275 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $13,177 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,177 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 1 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 444 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $164,261 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,643,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $164,261 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0570465 |
| Policy instance | 3 |
| Insurance contract or identification number | R0570465 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-03-01 | | Total amount of commissions paid to insurance broker | USD $2,753 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,652 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299864 |
| Policy instance | 2 |
| Insurance contract or identification number | 299864 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $4,253 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,253 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INC |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 1 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 457 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $151,248 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,479,044 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $151,248 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 70409 |
| Policy instance | 2 |
| Insurance contract or identification number | 70409 | | Number of Individuals Covered | 379 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $5,728 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,281 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,728 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOC., INC. |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 07315 |
| Policy instance | 3 |
| Insurance contract or identification number | 07315 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $2,033 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,667 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,033 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299864 |
| Policy instance | 4 |
| Insurance contract or identification number | 299864 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $3,406 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,706 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,406 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INS |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 07315 |
| Policy instance | 3 |
| Insurance contract or identification number | 07315 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $2,104 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,104 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 1 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 478 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $142,118 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,346,533 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $142,118 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOCIATES |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299864 |
| Policy instance | 4 |
| Insurance contract or identification number | 299864 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-03-01 | | Total amount of commissions paid to insurance broker | USD $3,277 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,277 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INS |
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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 70409 |
| Policy instance | 2 |
| Insurance contract or identification number | 70409 | | Number of Individuals Covered | 392 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $3,341 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,270 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,341 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOC., INC. |
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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 07315-00051 |
| Policy instance | 2 |
| Insurance contract or identification number | 07315-00051 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $1,921 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,921 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES |
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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00409-0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 00409-0001 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $4,807 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,807 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOC., INC. |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 4 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 490 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $132,639 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,162,306 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $132,639 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 299864 |
| Policy instance | 1 |
| Insurance contract or identification number | 299864 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-03-01 | | Total amount of commissions paid to insurance broker | USD $3,307 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,307 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C FOY & ASSOCIATES INS |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 2 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 475 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-03-01 | | Total amount of commissions paid to insurance broker | USD $140,893 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,968,259 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00409-0001 |
| Policy instance | 1 |
| Insurance contract or identification number | 00409-0001 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $5,230 | | Dental 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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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 52566 ) |
| Policy contract number | 00409-0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 00409-0001 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $4,967 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,967 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOC. |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 165275 |
| Policy instance | 3 |
| Insurance contract or identification number | 165275 | | Number of Individuals Covered | 490 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-03-01 | | Total amount of commissions paid to insurance broker | USD $125,115 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,735,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $125,115 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY |
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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7315-0051 |
| Policy instance | 1 |
| Insurance contract or identification number | 7315-0051 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,571 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,571 | | Insurance broker organization code? | 3 | | Insurance broker name | PETER C. FOY & ASSOC., INC. |
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