PACIFIC TRELLIS FRUIT has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BORG PRODUCE SALES, INC CAFETERIA PLAN
Measure | Date | Value |
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2019: BORG PRODUCE SALES, INC CAFETERIA PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 40 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 49 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 5 |
Total of all active and inactive participants | 2019-01-01 | 54 |
2018: BORG PRODUCE SALES, INC CAFETERIA PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 48 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 43 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 8 |
Total of all active and inactive participants | 2018-01-01 | 51 |
2017: BORG PRODUCE SALES, INC CAFETERIA PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 46 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 46 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 10 |
Total of all active and inactive participants | 2017-01-01 | 56 |
2016: BORG PRODUCE SALES, INC CAFETERIA PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 60 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 49 |
Total of all active and inactive participants | 2016-01-01 | 49 |
2015: BORG PRODUCE SALES, INC CAFETERIA PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 70 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 55 |
Total of all active and inactive participants | 2015-01-01 | 55 |
2014: BORG PRODUCE SALES, INC CAFETERIA PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 81 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 71 |
Total of all active and inactive participants | 2014-01-01 | 71 |
2013: BORG PRODUCE SALES, INC CAFETERIA PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 72 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 65 |
Total of all active and inactive participants | 2013-01-01 | 65 |
2012: BORG PRODUCE SALES, INC CAFETERIA PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 182 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 69 |
Total of all active and inactive participants | 2012-01-01 | 69 |
2011: BORG PRODUCE SALES, INC CAFETERIA PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 170 |
Total of all active and inactive participants | 2011-01-01 | 170 |
2009: BORG PRODUCE SALES, INC CAFETERIA PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-11-01 | 241 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 181 |
Total of all active and inactive participants | 2009-11-01 | 181 |
Total participants | 2009-11-01 | 0 |
2019: BORG PRODUCE SALES, INC CAFETERIA PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: BORG PRODUCE SALES, INC CAFETERIA PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: BORG PRODUCE SALES, INC CAFETERIA PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: BORG PRODUCE SALES, INC CAFETERIA PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: BORG PRODUCE SALES, INC CAFETERIA PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: BORG PRODUCE SALES, INC CAFETERIA PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: BORG PRODUCE SALES, INC CAFETERIA PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: BORG PRODUCE SALES, INC CAFETERIA PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: BORG PRODUCE SALES, INC CAFETERIA PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: BORG PRODUCE SALES, INC CAFETERIA PLAN 2009 form 5500 responses |
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2009-11-01 | Type of plan entity | Single employer plan |
2009-11-01 | Submission has been amended | No |
2009-11-01 | This submission is the final filing | No |
2009-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-11-01 | Plan is a collectively bargained plan | No |
2009-11-01 | Plan funding arrangement – Insurance | Yes |
2009-11-01 | Plan benefit arrangement – Insurance | Yes |
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | 5750436 |
Policy instance | 4 |
Insurance contract or identification number | 5750436 | Number of Individuals Covered | 31 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $190 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,702 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $190 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 249238 |
Policy instance | 3 |
Insurance contract or identification number | 249238 | Number of Individuals Covered | 25 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $11,630 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $232,596 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,630 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5750436 |
Policy instance | 2 |
Insurance contract or identification number | 5750436 | Number of Individuals Covered | 145 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,721 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,657 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,721 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 09W6229 |
Policy instance | 1 |
Insurance contract or identification number | 09W6229 | Number of Individuals Covered | 47 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $21,343 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $304,898 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,245 | Insurance broker organization code? | 3 |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 249238 |
Policy instance | 3 |
Insurance contract or identification number | 249238 | Number of Individuals Covered | 23 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $18,074 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $215,215 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,694 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05750436 |
Policy instance | 2 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 157 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,409 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $58,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,409 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 717968 |
Policy instance | 1 |
Insurance contract or identification number | 717968 | Number of Individuals Covered | 54 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $22,890 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $326,991 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,350 | Insurance broker organization code? | 3 |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 249238 |
Policy instance | 4 |
Insurance contract or identification number | 249238 | Number of Individuals Covered | 25 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $15,220 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $202,939 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,147 | Insurance broker organization code? | 3 | Insurance broker name | WARNER PACIFIC INS SERVICES DB |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 3 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 54 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $292 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,339 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $292 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 2 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 93 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,807 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,134 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,807 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 717968 |
Policy instance | 1 |
Insurance contract or identification number | 717968 | Number of Individuals Covered | 55 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $20,496 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $292,793 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,640 | Insurance broker organization code? | 3 | Insurance broker name | WARNER PACIFIC INSURANCE SERVICES |
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0001538 |
Policy instance | 4 |
Insurance contract or identification number | W0001538 | Number of Individuals Covered | 59 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $28,059 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $561,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,059 | Insurance broker organization code? | 1 | Insurance broker name | DIALANI ASSOC INC INS & FIN SV |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 1 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 121 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,697 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,846 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,697 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC INSURANCE |
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BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) |
Policy contract number | W0001538 |
Policy instance | 2 |
Insurance contract or identification number | W0001538 | Number of Individuals Covered | 68 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $123 | 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 $2,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $123 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCI INC INS & FIN SV |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 3 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 66 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $360 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,259 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $360 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC. |
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BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) |
Policy contract number | W0001538 |
Policy instance | 3 |
Insurance contract or identification number | W0001538 | Number of Individuals Covered | 72 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $120 | 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 $2,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $120 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCI INC INS & FIN SV |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 30031122 |
Policy instance | 1 |
Insurance contract or identification number | 30031122 | Number of Individuals Covered | 57 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $603 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,069 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $603 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC |
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0001538 |
Policy instance | 5 |
Insurance contract or identification number | W0001538 | Number of Individuals Covered | 64 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $30,790 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $615,802 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,790 | Insurance broker organization code? | 1 | Insurance broker name | DIALANI ASSOC INC INS & FIN SV |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 2 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 138 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,470 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,330 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,470 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC INSURANCE |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 4 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 81 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $389 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,640 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $389 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC. |
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | |
Policy instance | 5 |
Number of Individuals Covered | 147 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $25,075 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $503,811 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,075 | Insurance broker organization code? | 1 | Insurance broker name | DIALANI ASSOC INC INS & FIN SV |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 4 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 85 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $360 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $360 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC. |
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BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) |
Policy contract number | |
Policy instance | 3 |
Number of Individuals Covered | 66 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $98 | 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 $1,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $98 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCI INC INS & FIN SV |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 2 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 116 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,209 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,350 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,209 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC INSURANCE |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 30031122 |
Policy instance | 1 |
Insurance contract or identification number | 30031122 | Number of Individuals Covered | 47 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $409 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,182 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $409 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 2 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 142 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,010 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $80,009 | Commission paid to Insurance Broker | USD $4,010 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC INSURANCE |
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | |
Policy instance | 3 |
Number of Individuals Covered | 75 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $149 | 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 $2,968 | Commission paid to Insurance Broker | USD $149 | Insurance broker name | DIALANI ASSOCI INC INS & FIN SV |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | |
Policy instance | 1 |
Number of Individuals Covered | 52 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $475 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,503 | Commission paid to Insurance Broker | USD $475 | Insurance broker organization code? | 3 | Insurance broker name | DIALANI ASSOCIATES INC |
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CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | |
Policy instance | 4 |
Number of Individuals Covered | 154 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $37,886 | Total amount of fees paid to insurance company | USD $19,330 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $757,735 | Commission paid to Insurance Broker | USD $37,886 | Amount paid for insurance broker fees | 19330 | Additional information about fees paid to insurance broker | BONUS OVERIDE ALLOCATION | Insurance broker name | DIALANI ASSOC INC INS & FIN SV |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00419091 |
Policy instance | 4 |
Insurance contract or identification number | 00419091 | Number of Individuals Covered | 140 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,098 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,104 |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 5 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 195 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,481 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 230966 |
Policy instance | 3 |
Insurance contract or identification number | 230966 | Number of Individuals Covered | 106 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $8,252 | Total amount of fees paid to insurance company | USD $15,000 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $297,207 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1016340 |
Policy instance | 2 |
Insurance contract or identification number | 1016340 | Number of Individuals Covered | 189 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,415 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $108,457 |
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UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 353138 |
Policy instance | 1 |
Insurance contract or identification number | 353138 | Number of Individuals Covered | 15 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,141 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $171,372 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00419091 |
Policy instance | 1 |
Insurance contract or identification number | 00419091 | Number of Individuals Covered | 155 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
Policy contract number | KM05750436 |
Policy instance | 3 |
Insurance contract or identification number | KM05750436 | Number of Individuals Covered | 140 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 805185 |
Policy instance | 5 |
Insurance contract or identification number | 805185 | Number of Individuals Covered | 178 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-032752 |
Policy instance | 2 |
Insurance contract or identification number | 010-032752 | Number of Individuals Covered | 358 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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