HOLTHOUSE CARLIN & VAN TRIGT LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN
401k plan membership statisitcs for HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN
Measure | Date | Value |
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2021: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 622 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 657 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 2 |
Total of all active and inactive participants | 2021-07-01 | 659 |
Total participants | 2021-07-01 | 659 |
2020: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 614 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 622 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 2 |
Total of all active and inactive participants | 2020-07-01 | 624 |
Total participants | 2020-07-01 | 624 |
2019: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 588 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 616 |
Number of retired or separated participants receiving benefits | 2019-07-01 | 10 |
Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
Total of all active and inactive participants | 2019-07-01 | 626 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-07-01 | 0 |
Total participants | 2019-07-01 | 626 |
Number of participants with account balances | 2019-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-07-01 | 0 |
2018: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 528 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 588 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 594 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-07-01 | 0 |
Total participants | 2018-07-01 | 594 |
Number of participants with account balances | 2018-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-07-01 | 0 |
2017: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 502 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 528 |
Number of retired or separated participants receiving benefits | 2017-07-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
Total of all active and inactive participants | 2017-07-01 | 535 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-07-01 | 0 |
Total participants | 2017-07-01 | 535 |
Number of participants with account balances | 2017-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-07-01 | 0 |
2016: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 437 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 493 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
Total of all active and inactive participants | 2016-07-01 | 495 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-07-01 | 0 |
Total participants | 2016-07-01 | 495 |
Number of participants with account balances | 2016-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-07-01 | 0 |
2015: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 384 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 435 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
Total of all active and inactive participants | 2015-07-01 | 438 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-07-01 | 0 |
Total participants | 2015-07-01 | 438 |
Number of participants with account balances | 2015-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-07-01 | 0 |
2014: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 356 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 390 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
Total of all active and inactive participants | 2014-07-01 | 392 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-07-01 | 0 |
Total participants | 2014-07-01 | 392 |
Number of participants with account balances | 2014-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2014-07-01 | 0 |
2013: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 319 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 359 |
Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
Total of all active and inactive participants | 2013-07-01 | 359 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
Total participants | 2013-07-01 | 359 |
2012: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 277 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 309 |
Number of retired or separated participants receiving benefits | 2012-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
Total of all active and inactive participants | 2012-07-01 | 310 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
Total participants | 2012-07-01 | 310 |
2011: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 258 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 272 |
Number of retired or separated participants receiving benefits | 2011-07-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
Total of all active and inactive participants | 2011-07-01 | 278 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-07-01 | 0 |
Total participants | 2011-07-01 | 278 |
Number of participants with account balances | 2011-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-07-01 | 0 |
2010: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-07-01 | 249 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 251 |
Number of retired or separated participants receiving benefits | 2010-07-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2010-07-01 | 0 |
Total of all active and inactive participants | 2010-07-01 | 258 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-07-01 | 0 |
Total participants | 2010-07-01 | 258 |
Number of participants with account balances | 2010-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-07-01 | 0 |
2009: HOLTHOUSE CARLIN & VAN TRIGT LLP WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 251 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 239 |
Number of retired or separated participants receiving benefits | 2009-07-01 | 10 |
Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
Total of all active and inactive participants | 2009-07-01 | 249 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-07-01 | 0 |
Total participants | 2009-07-01 | 249 |
Number of participants with account balances | 2009-07-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-07-01 | 0 |
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 803742G |
Policy instance | 5 |
Insurance contract or identification number | 803742G | Number of Individuals Covered | 657 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $58,766 | Total amount of fees paid to insurance company | USD $3,714 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D AND STD | Welfare Benefit Premiums Paid to Carrier | USD $360,059 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,766 | Amount paid for insurance broker fees | 3714 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 802428 |
Policy instance | 4 |
Insurance contract or identification number | 802428 | Number of Individuals Covered | 123 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $6,769 | Welfare Benefit Premiums Paid to Carrier | USD $31,651 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,769 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 3 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 928 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $167,844 | Total amount of fees paid to insurance company | USD $23,457 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,894,388 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $167,844 | Amount paid for insurance broker fees | 23457 | Additional information about fees paid to insurance broker | 2021 SIGNATURE VISION, MEDICAL, DENTAL RETENTION INCENTIVE RISK | Insurance broker organization code? | 3 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 2 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 154 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $45,163 | Welfare Benefit Premiums Paid to Carrier | USD $1,140,675 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,163 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 267 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $58,877 | Total amount of fees paid to insurance company | USD $758 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,191,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,877 | Amount paid for insurance broker fees | 758 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 257 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $69,563 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,381,248 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,563 | Insurance broker organization code? | 3 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 2 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 160 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $41,208 | Welfare Benefit Premiums Paid to Carrier | USD $1,038,291 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,208 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 802428 |
Policy instance | 4 |
Insurance contract or identification number | 802428 | Number of Individuals Covered | 94 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $3,496 | Welfare Benefit Premiums Paid to Carrier | USD $19,990 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,496 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 3 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 856 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $158,958 | Total amount of fees paid to insurance company | USD $12,280 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,522,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $158,958 | Amount paid for insurance broker fees | 12280 | Additional information about fees paid to insurance broker | 2020 SIGNATURE MEDICAL RETENTION INCENTIVE RISK | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 803742G |
Policy instance | 5 |
Insurance contract or identification number | 803742G | Number of Individuals Covered | 622 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $39,915 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D AND STD | Welfare Benefit Premiums Paid to Carrier | USD $266,099 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,915 | Insurance broker organization code? | 3 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 2 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 153 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $39,214 | Welfare Benefit Premiums Paid to Carrier | USD $980,862 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,214 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 3 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 854 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $150,988 | Total amount of fees paid to insurance company | USD $5,940 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,163,736 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $150,988 | Amount paid for insurance broker fees | 5940 | Additional information about fees paid to insurance broker | 2019 PREMIER PRODUCER PROGRAM - MEDICAL RETENTION RISK | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 802428 |
Policy instance | 4 |
Insurance contract or identification number | 802428 | Number of Individuals Covered | 53 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $1,951 | Welfare Benefit Premiums Paid to Carrier | USD $13,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,951 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 803742G |
Policy instance | 5 |
Insurance contract or identification number | 803742G | Number of Individuals Covered | 616 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $40,176 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D AND STD | Welfare Benefit Premiums Paid to Carrier | USD $267,837 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,176 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 288 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $64,229 | Total amount of fees paid to insurance company | USD $1,725 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,397,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64,229 | Amount paid for insurance broker fees | 1725 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 802428 |
Policy instance | 4 |
Insurance contract or identification number | 802428 | Number of Individuals Covered | 33 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $491 | Welfare Benefit Premiums Paid to Carrier | USD $3,588 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $491 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 3 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 825 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $181,539 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D & STD | Welfare Benefit Premiums Paid to Carrier | USD $3,310,333 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $181,539 | Insurance broker organization code? | 3 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 2 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 159 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $40,692 | Welfare Benefit Premiums Paid to Carrier | USD $961,079 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,692 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 269 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $56,778 | Total amount of fees paid to insurance company | USD $1,631 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,048,375 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,778 | Amount paid for insurance broker fees | 1631 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 3 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 767 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $157,862 | Total amount of fees paid to insurance company | USD $2,184 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D & STD | Welfare Benefit Premiums Paid to Carrier | USD $3,203,410 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 2 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 125 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $28,251 | Welfare Benefit Premiums Paid to Carrier | USD $785,378 | 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 | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 234 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $48,945 | Total amount of fees paid to insurance company | USD $2,252 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,067,945 | 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 | 226239 |
Policy instance | 1 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 163 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $46,385 | Total amount of fees paid to insurance company | USD $38 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $683,287 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,110 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 38 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | BURNHAM BENEFITS INSURANCE SERVICES |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00501131 |
Policy instance | 2 |
Insurance contract or identification number | 00501131 | Number of Individuals Covered | 418 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $26,921 | Total amount of fees paid to insurance company | USD $3,280 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $336,504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,328 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3280 | Additional information about fees paid to insurance broker | GENERAL AGENT FEES | Insurance broker name | BURNHAM BENEFITS INSURANCE SERVICES |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0803905HNO |
Policy instance | 3 |
Insurance contract or identification number | 0803905HNO | Number of Individuals Covered | 104 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $22,688 | Welfare Benefit Premiums Paid to Carrier | USD $596,301 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,866 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0803905 |
Policy instance | 4 |
Insurance contract or identification number | 0803905 | Number of Individuals Covered | 715 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $110,513 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $2,407,908 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,794 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00501131 |
Policy instance | 7 |
Insurance contract or identification number | 00501131 | Number of Individuals Covered | 377 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $22,688 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $283,604 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,688 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 165938 |
Policy instance | 6 |
Insurance contract or identification number | 165938 | Number of Individuals Covered | 390 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,238 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,232 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,238 | Insurance broker organization code? | 3 | Insurance broker name | BERNS/ROSENTHAL |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 5 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 129 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $4,575 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $30,501 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,575 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010055952 |
Policy instance | 4 |
Insurance contract or identification number | 000010055952 | Number of Individuals Covered | 390 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $3,689 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,697 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,689 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 3 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 136 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $31,864 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $434,189 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,864 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010104500000 |
Policy instance | 2 |
Insurance contract or identification number | 000010104500000 | Number of Individuals Covered | 390 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $5,872 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,149 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,872 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 151770 |
Policy instance | 1 |
Insurance contract or identification number | 151770 | Number of Individuals Covered | 475 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $102,077 | Total amount of fees paid to insurance company | USD $324 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,548,637 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $102,077 | Amount paid for insurance broker fees | 324 | Additional information about fees paid to insurance broker | EDUCATION & TRAINING | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010104500000 |
Policy instance | 3 |
Insurance contract or identification number | 000010104500000 | Number of Individuals Covered | 359 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $5,329 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,524 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,329 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 165938 |
Policy instance | 7 |
Insurance contract or identification number | 165938 | Number of Individuals Covered | 359 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $1,115 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,132 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,115 | Insurance broker organization code? | 3 | Insurance broker name | BERNS/ROSENTHAL |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 6 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 124 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $3,972 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $26,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,972 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010055952 |
Policy instance | 5 |
Insurance contract or identification number | 000010055952 | Number of Individuals Covered | 359 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $3,331 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $47,588 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,331 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 4 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 106 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $25,451 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $408,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,451 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 909 |
Policy instance | 1 |
Insurance contract or identification number | 909 | Number of Individuals Covered | 567 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $34,417 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $343,816 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,417 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 151770 |
Policy instance | 2 |
Insurance contract or identification number | 151770 | Number of Individuals Covered | 462 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $82,006 | Total amount of fees paid to insurance company | USD $4,764 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,029,160 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82,006 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4764 | Additional information about fees paid to insurance broker | EDUCATION & TRAINING | Insurance broker name | JAMES C. JENKINS |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 151770 |
Policy instance | 2 |
Insurance contract or identification number | 151770 | Number of Individuals Covered | 421 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $68,101 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,681,357 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,101 | Insurance broker organization code? | 3 | Insurance broker name | BERNS/ROSENTHAL |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 165938 |
Policy instance | 7 |
Insurance contract or identification number | 165938 | Number of Individuals Covered | 308 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $970 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,009 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $970 | Insurance broker organization code? | 3 | Insurance broker name | BERNS/ROSENTHAL |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 6 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 97 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $2,946 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,946 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010055952 |
Policy instance | 5 |
Insurance contract or identification number | 000010055952 | Number of Individuals Covered | 308 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $2,843 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,843 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 226239 |
Policy instance | 4 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 90 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $23,086 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $338,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,086 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010104500000 |
Policy instance | 3 |
Insurance contract or identification number | 000010104500000 | Number of Individuals Covered | 308 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $4,542 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,281 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,542 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 909 |
Policy instance | 1 |
Insurance contract or identification number | 909 | Number of Individuals Covered | 481 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $29,937 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $299,241 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,937 | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT INSURANCE SERVICES OF LA |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 151770 |
Policy instance | 2 |
Insurance contract or identification number | 151770 | Number of Individuals Covered | 348 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $72,817 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,667,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010104500000 |
Policy instance | 3 |
Insurance contract or identification number | 000010104500000 | Number of Individuals Covered | 272 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $4,401 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,341 | 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 | 226239 |
Policy instance | 4 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 83 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $21,213 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $258,877 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010055952 |
Policy instance | 5 |
Insurance contract or identification number | 000010055952 | Number of Individuals Covered | 272 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $2,696 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $38,512 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 165938 |
Policy instance | 7 |
Insurance contract or identification number | 165938 | Number of Individuals Covered | 269 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $877 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,483 | 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: 00000 ) |
Policy contract number | 909 |
Policy instance | 1 |
Insurance contract or identification number | 909 | Number of Individuals Covered | 465 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $27,019 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $270,189 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 6 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 84 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $2,492 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 165938 |
Policy instance | 7 |
Insurance contract or identification number | 165938 | Number of Individuals Covered | 0 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $909 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010055952 |
Policy instance | 5 |
Insurance contract or identification number | 000010055952 | Number of Individuals Covered | 253 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $2,040 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,142 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 6 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 73 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $2,097 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $13,978 | 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 | 226239 |
Policy instance | 4 |
Insurance contract or identification number | 226239 | Number of Individuals Covered | 38 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $10,261 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $175,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010104500000 |
Policy instance | 3 |
Insurance contract or identification number | 000010104500000 | Number of Individuals Covered | 253 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $4,277 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,512 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 151770 |
Policy instance | 2 |
Insurance contract or identification number | 151770 | Number of Individuals Covered | 348 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $55,452 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,508,595 | 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: 00000 ) |
Policy contract number | 909 |
Policy instance | 1 |
Insurance contract or identification number | 909 | Number of Individuals Covered | 256 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $25,114 | Total amount of fees paid to insurance company | USD $32,823 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $250,608 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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