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SOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS 401k Plan overview

Plan NameSOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS
Plan identification number 501

SOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    SOUTHWEST RESEARCH INSTITUTE has sponsored the creation of one or more 401k plans.

    Company Name:SOUTHWEST RESEARCH INSTITUTE
    Employer identification number (EIN):741070544
    NAIC Classification:541700

    Additional information about SOUTHWEST RESEARCH INSTITUTE

    Jurisdiction of Incorporation: Texas Secretary of State
    Incorporation Date: 1966-10-13
    Company Identification Number: 0022861301
    Legal Registered Office Address: 6220 CULEBRA RD

    SAN ANTONIO
    United States of America (USA)
    78238

    More information about SOUTHWEST RESEARCH INSTITUTE

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan SOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012020-01-01
    5012019-01-01
    5012018-01-01
    5012017-01-01BETH ANN RAFFERTY
    5012016-01-01BETH ANN RAFFERTY
    5012015-01-01BETH ANN RAFFERTY
    5012014-01-01BETH ANN RAFFERTY
    5012013-01-01BETH ANN RAFFERTY
    5012012-01-01BETH ANN RAFFERTY BETH ANN RAFFERTY2013-10-08
    5012011-01-01BETH ANN RAFFERTY BETH ANN RAFFERTY2012-10-12
    5012010-01-01BETH ANN RAFFERTY BETH ANN RAFFERTY2011-09-09
    5012009-01-01JOHN F. SPRENCEL

    Plan Statistics for SOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS

    401k plan membership statisitcs for SOUTHWEST RESEARCH INSTITUTE EMPLOYEES' INSURANCE PROGRAMS

    Measure Date Value
    2020
    Total participants, beginning-of-year2020-01-013,488
    Total number of active participants reported on line 7a of the Form 55002020-01-012,853
    Number of retired or separated participants receiving benefits2020-01-01686
    Total of all active and inactive participants2020-01-013,539
    2019
    Total participants, beginning-of-year2019-01-013,272
    Total number of active participants reported on line 7a of the Form 55002019-01-012,813
    Number of retired or separated participants receiving benefits2019-01-01675
    Total of all active and inactive participants2019-01-013,488
    2018
    Total participants, beginning-of-year2018-01-013,194
    Total number of active participants reported on line 7a of the Form 55002018-01-012,635
    Number of retired or separated participants receiving benefits2018-01-01637
    Total of all active and inactive participants2018-01-013,272
    2017
    Total participants, beginning-of-year2017-01-013,249
    Total number of active participants reported on line 7a of the Form 55002017-01-012,576
    Number of retired or separated participants receiving benefits2017-01-01618
    Total of all active and inactive participants2017-01-013,194
    2016
    Total participants, beginning-of-year2016-01-013,287
    Total number of active participants reported on line 7a of the Form 55002016-01-012,673
    Number of retired or separated participants receiving benefits2016-01-01576
    Total of all active and inactive participants2016-01-013,249
    2015
    Total participants, beginning-of-year2015-01-013,328
    Total number of active participants reported on line 7a of the Form 55002015-01-012,744
    Number of retired or separated participants receiving benefits2015-01-01543
    Total of all active and inactive participants2015-01-013,287
    2014
    Total participants, beginning-of-year2014-01-013,381
    Total number of active participants reported on line 7a of the Form 55002014-01-012,791
    Number of retired or separated participants receiving benefits2014-01-01537
    Total of all active and inactive participants2014-01-013,328
    2013
    Total participants, beginning-of-year2013-01-013,440
    Total number of active participants reported on line 7a of the Form 55002013-01-012,855
    Number of retired or separated participants receiving benefits2013-01-01526
    Total of all active and inactive participants2013-01-013,381
    2012
    Total participants, beginning-of-year2012-01-013,481
    Total number of active participants reported on line 7a of the Form 55002012-01-012,921
    Number of retired or separated participants receiving benefits2012-01-01519
    Total of all active and inactive participants2012-01-013,440
    2011
    Total participants, beginning-of-year2011-01-013,749
    Total number of active participants reported on line 7a of the Form 55002011-01-013,002
    Number of retired or separated participants receiving benefits2011-01-01479
    Total of all active and inactive participants2011-01-013,481
    2010
    Total participants, beginning-of-year2010-01-013,850
    Total number of active participants reported on line 7a of the Form 55002010-01-013,109
    Number of retired or separated participants receiving benefits2010-01-01640
    Total of all active and inactive participants2010-01-013,749
    2009
    Total participants, beginning-of-year2009-01-014,033
    Total number of active participants reported on line 7a of the Form 55002009-01-013,219
    Number of retired or separated participants receiving benefits2009-01-01631
    Total of all active and inactive participants2009-01-013,850

    Form 5500 Responses

    2020
    2020-01-01Type of plan entitySingle employer plan
    2020-01-01Plan funding arrangement – InsuranceYes
    2020-01-01Plan benefit arrangement – InsuranceYes
    2019
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Plan funding arrangement – InsuranceYes
    2019-01-01Plan benefit arrangement – InsuranceYes
    2018
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Plan funding arrangement – InsuranceYes
    2018-01-01Plan benefit arrangement – InsuranceYes
    2017
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Plan funding arrangement – InsuranceYes
    2017-01-01Plan benefit arrangement – InsuranceYes
    2016
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Plan funding arrangement – InsuranceYes
    2016-01-01Plan benefit arrangement – InsuranceYes
    2015
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2014
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2013
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Plan funding arrangement – InsuranceYes
    2013-01-01Plan benefit arrangement – InsuranceYes
    2012
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Plan funding arrangement – General assets of the sponsorYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2011
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Plan funding arrangement – General assets of the sponsorYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2010
    2010-01-01Type of plan entitySingle employer plan
    2010-01-01Plan funding arrangement – General assets of the sponsorYes
    2010-01-01Plan benefit arrangement – InsuranceYes
    2009
    2009-01-01Type of plan entitySingle employer plan
    2009-01-01This submission is the final filingNo
    2009-01-01Plan funding arrangement – General assets of the sponsorYes
    2009-01-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 9
    Insurance contract or identification numberBXMA
    Number of Individuals Covered819
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Welfare Benefit Premiums Paid to CarrierUSD $1,786,504
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 7
    Insurance contract or identification number7550001
    Number of Individuals Covered573
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $86,499
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 6
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered831
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,992,092
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 5
    Insurance contract or identification numberC30551
    Number of Individuals Covered31
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $8,584
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $50,493
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,049
    Insurance broker organization code?3
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered92
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $414,727
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered68
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $433,428
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered2284
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $236,151
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered5
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $886
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,364
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $886
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberVDT962617
    Policy instance 18
    Insurance contract or identification numberVDT962617
    Number of Individuals Covered486
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedSHORT TERM DISABILITY
    Welfare Benefit Premiums Paid to CarrierUSD $155,665
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 8
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2853
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberAI960439
    Policy instance 15
    Insurance contract or identification numberAI960439
    Number of Individuals Covered434
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Temporary Disability Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $94,765
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 10
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2748
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $203,221
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 11
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2748
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,546,373
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 12
    Insurance contract or identification number01109420
    Number of Individuals Covered1009
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $295,949
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0903023
    Policy instance 13
    Insurance contract or identification number0903023
    Number of Individuals Covered272
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,352,215
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberCI960141
    Policy instance 14
    Insurance contract or identification numberCI960141
    Number of Individuals Covered484
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCRITICAL ILLNESS
    Welfare Benefit Premiums Paid to CarrierUSD $206,909
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
    Policy contract number
    Policy instance 16
    Number of Individuals Covered692
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $38,432
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $192,120
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $38,432
    Insurance broker organization code?3
    DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
    Policy contract number19097
    Policy instance 17
    Insurance contract or identification number19097
    Number of Individuals Covered865
    Insurance policy start date2020-01-01
    Insurance policy end date2020-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $330,060
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 6
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered802
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,852,928
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 7
    Insurance contract or identification number7550001
    Number of Individuals Covered549
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $74,192
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 8
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2813
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $79,372
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 5
    Insurance contract or identification numberC30551
    Number of Individuals Covered26
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $16,281
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $60,298
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $7,839
    Insurance broker organization code?3
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered98
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $428,624
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered61
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $412,944
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered2155
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $180,407
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered6
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $1,096
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $4,398
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,096
    Insurance broker organization code?3
    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 9
    Insurance contract or identification numberBXMA
    Number of Individuals Covered779
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $13,992
    Total amount of fees paid to insurance companyUSD $0
    Welfare Benefit Premiums Paid to CarrierUSD $1,640,020
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,992
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 10
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2682
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $162,900
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberVDT962617
    Policy instance 18
    Insurance contract or identification numberVDT962617
    Number of Individuals Covered409
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedSHORT TERM DISABILITY
    Welfare Benefit Premiums Paid to CarrierUSD $129,392
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
    Policy contract number19097
    Policy instance 17
    Insurance contract or identification number19097
    Number of Individuals Covered811
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $304,517
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
    Policy contract number
    Policy instance 16
    Number of Individuals Covered612
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $30,161
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $150,776
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $30,161
    Insurance broker organization code?3
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberAI960439
    Policy instance 15
    Insurance contract or identification numberAI960439
    Number of Individuals Covered362
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Temporary Disability Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $72,049
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberCI960141
    Policy instance 14
    Insurance contract or identification numberCI960141
    Number of Individuals Covered449
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCRITICAL ILLNESS
    Welfare Benefit Premiums Paid to CarrierUSD $174,132
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0903023
    Policy instance 13
    Insurance contract or identification number0903023
    Number of Individuals Covered333
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,470,229
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 12
    Insurance contract or identification number01109420
    Number of Individuals Covered945
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $281,399
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 11
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2682
    Insurance policy start date2019-01-01
    Insurance policy end date2019-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,225,746
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 8
    Insurance contract or identification number7550001
    Number of Individuals Covered538
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $71,014
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 7
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered765
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,721,298
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 6
    Insurance contract or identification numberC30551
    Number of Individuals Covered33
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $13,962
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $82,126
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,212
    Insurance broker organization code?3
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 5
    Insurance contract or identification number28720
    Number of Individuals Covered85
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $8,873
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $127,089
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,873
    Insurance broker organization code?3
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered101
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $465,461
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered60
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $367,072
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered2024
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $172,418
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered7
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $1,132
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $5,508
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,132
    Insurance broker organization code?3
    METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
    Policy contract number
    Policy instance 18
    Number of Individuals Covered459
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $7,758
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $29,838
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,968
    Insurance broker organization code?3
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 10
    Number of Individuals Covered42
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $26,537
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $102,053
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $20,414
    Insurance broker organization code?3
    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 11
    Insurance contract or identification numberBXMA
    Number of Individuals Covered747
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Welfare Benefit Premiums Paid to CarrierUSD $1,739,277
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 9
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2635
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
    Policy contract number19097
    Policy instance 19
    Insurance contract or identification number19097
    Number of Individuals Covered738
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $285,163
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberAI960439
    Policy instance 17
    Insurance contract or identification numberAI960439
    Number of Individuals Covered266
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Temporary Disability Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $57,650
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberCI960141
    Policy instance 16
    Insurance contract or identification numberCI960141
    Number of Individuals Covered407
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCRITICAL ILLNESS
    Welfare Benefit Premiums Paid to CarrierUSD $161,890
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0903023
    Policy instance 15
    Insurance contract or identification number0903023
    Number of Individuals Covered336
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,558,347
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 14
    Insurance contract or identification number01109420
    Number of Individuals Covered899
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $265,893
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 13
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2531
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,381,602
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 12
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2531
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $190,073
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 8
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered623
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $25,557
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $25,557
    Insurance broker organization code?3
    Insurance broker nameJOHN V. WYSONG
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 7
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered707
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,575,347
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 6
    Insurance contract or identification numberC30551
    Number of Individuals Covered36
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $14,625
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $86,036
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,605
    Insurance broker organization code?3
    Insurance broker nameASPEN REINSURANCE GROUP, INC
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 5
    Insurance contract or identification number28720
    Number of Individuals Covered87
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $9,052
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $122,437
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,052
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered117
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $512,887
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered53
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $312,345
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1961
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $167,606
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered7
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $1,328
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $5,508
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,328
    Insurance broker organization code?3
    Insurance broker nameJOHN MIKE COLLINS
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 9
    Insurance contract or identification number7550001
    Number of Individuals Covered490
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $69,401
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 10
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2576
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberAI960439
    Policy instance 18
    Insurance contract or identification numberAI960439
    Number of Individuals Covered137
    Insurance policy start date2017-06-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Temporary Disability Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $16,658
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberCI960141
    Policy instance 17
    Insurance contract or identification numberCI960141
    Number of Individuals Covered349
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCRITICAL ILLNESS
    Welfare Benefit Premiums Paid to CarrierUSD $139,343
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0903023
    Policy instance 16
    Insurance contract or identification number0903023
    Number of Individuals Covered376
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $3,843,184
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 15
    Insurance contract or identification number01109420
    Number of Individuals Covered889
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $271,138
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 14
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2475
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,121,375
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 13
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2475
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $159,071
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 12
    Insurance contract or identification numberBXMA
    Number of Individuals Covered707
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Welfare Benefit Premiums Paid to CarrierUSD $1,557,442
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 11
    Number of Individuals Covered433
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Total amount of commissions paid to insurance brokerUSD $35,617
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $136,975
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $27,399
    Insurance broker organization code?3
    Insurance broker nameBAFFIN BAY MARKETING GROUP, LLC
    UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
    Policy contract number0903023
    Policy instance 16
    Insurance contract or identification number0903023
    Number of Individuals Covered166
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,928,879
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 9
    Insurance contract or identification number7550001
    Number of Individuals Covered509
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $68,882
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered8
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $401
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $4,398
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $401
    Insurance broker organization code?3
    Insurance broker nameJOHN MIKE COLLINS
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1965
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $140,588
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered52
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $289,754
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered127
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $506,209
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 5
    Insurance contract or identification number28720
    Number of Individuals Covered76
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $9,984
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $133,953
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,984
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 6
    Insurance contract or identification numberC30551
    Number of Individuals Covered97
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $10,939
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedCANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $109,407
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,939
    Insurance broker organization code?3
    Insurance broker nameOLDHAM C. WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 7
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered661
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,325,144
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 8
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered566
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $23,312
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $23,312
    Insurance broker organization code?3
    Insurance broker nameJOHN WYSONG
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 10
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2744
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $4,560
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 11
    Number of Individuals Covered368
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $25,986
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $129,917
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $25,986
    Insurance broker nameOLDHAM C. WEEKS (BB10408)
    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 12
    Insurance contract or identification numberBXMA
    Number of Individuals Covered645
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Welfare Benefit Premiums Paid to CarrierUSD $1,286,415
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 13
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2662
    Insurance policy start date2015-07-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $167,120
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 14
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2662
    Insurance policy start date2015-07-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,167,706
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 15
    Insurance contract or identification number01109420
    Number of Individuals Covered917
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 10
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered529
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $21,498
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $21,498
    Insurance broker organization code?3
    Insurance broker nameJOHN WYSONG
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 12
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2791
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $1,685
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 13
    Number of Individuals Covered345
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $24,653
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $123,248
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $24,653
    Insurance broker organization code?3
    Insurance broker nameOLDHAM WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G-
    Policy instance 14
    Insurance contract or identification number398477G-
    Number of Individuals Covered2882
    Insurance policy start date2014-01-01
    Insurance policy end date2014-06-30
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $3,395
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $619,203
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees3395
    Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number08868
    Policy instance 15
    Insurance contract or identification number08868
    Number of Individuals Covered249
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,287,319
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
    Policy contract numberBXMA
    Policy instance 16
    Insurance contract or identification numberBXMA
    Number of Individuals Covered626
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Welfare Benefit Premiums Paid to CarrierUSD $1,163,894
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 967622
    Policy instance 17
    Insurance contract or identification numberOK 967622
    Number of Individuals Covered2681
    Insurance policy start date2014-07-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $75,712
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberFLX966069
    Policy instance 18
    Insurance contract or identification numberFLX966069
    Number of Individuals Covered2681
    Insurance policy start date2014-07-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $425,082
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 9
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered614
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,069,179
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 8
    Insurance contract or identification numberC30551
    Number of Individuals Covered105
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $8,574
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedINDIVIDUAL CANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $85,735
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,574
    Insurance broker organization code?3
    Insurance broker nameOLDHAM C. WEEKS
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 7
    Insurance contract or identification number28720
    Number of Individuals Covered97
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $10,066
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $135,656
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,066
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 11
    Insurance contract or identification number7550001
    Number of Individuals Covered480
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $67,219
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract number0001771
    Policy instance 1
    Insurance contract or identification number0001771
    Number of Individuals Covered5
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $367
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $4,068
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $367
    Insurance broker organization code?3
    Insurance broker nameJOHN MIKE COLLINS
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1876
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $145,516
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered49
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $264,996
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered92
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $507,033
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 5
    Insurance contract or identification number01109420
    Number of Individuals Covered902
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 960314
    Policy instance 6
    Insurance contract or identification numberOK 960314
    Number of Individuals Covered1028
    Insurance policy start date2014-01-01
    Insurance policy end date2014-06-30
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $47,315
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract numberC366A-B
    Policy instance 1
    Insurance contract or identification numberC366A-B
    Number of Individuals Covered9
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $12,069
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 960314
    Policy instance 6
    Insurance contract or identification numberOK 960314
    Number of Individuals Covered1024
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $105,009
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 5
    Insurance contract or identification number01109420
    Number of Individuals Covered890
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered97
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $506,270
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered53
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $258,032
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1915
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $161,808
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 8
    Insurance contract or identification numberC30551
    Number of Individuals Covered112
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $11,961
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedINDIVIDUAL CANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $118,806
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,961
    Insurance broker organization code?3
    Insurance broker nameOLDHAM C. WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 9
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered573
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,095,036
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SILVERSCRIPT (National Association of Insurance Commissioners NAIC id number: 52411 )
    Policy contract number10111
    Policy instance 10
    Insurance contract or identification number10111
    Number of Individuals Covered598
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $31,547
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Welfare Benefit Premiums Paid to CarrierUSD $1,062,985
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees31547
    Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
    Insurance broker organization code?3
    Insurance broker nameGROUP ADMINISTRATIVE CONCEPTS
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 11
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered493
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $20,002
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $20,002
    Insurance broker organization code?3
    Insurance broker nameJOHN WYSONG
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 13
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2882
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $66,461
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 7
    Insurance contract or identification number28720
    Number of Individuals Covered101
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $9,472
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $97,386
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,472
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 14
    Number of Individuals Covered364
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $28,212
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $141,060
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $28,212
    Insurance broker organization code?3
    Insurance broker nameOLDHAM WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G-
    Policy instance 15
    Insurance contract or identification number398477G-
    Number of Individuals Covered2882
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $5,133
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $974,261
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees5133
    Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number08868
    Policy instance 16
    Insurance contract or identification number08868
    Number of Individuals Covered265
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,057,352
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 12
    Insurance contract or identification number7550001
    Number of Individuals Covered479
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $73,958
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 14
    Number of Individuals Covered494
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $24,912
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $124,560
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $24,912
    Insurance broker organization code?3
    Insurance broker nameOLDHAM WEEKS
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 13
    Insurance contract or identification numberABL960599
    Number of Individuals Covered3028
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $6,382
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 15
    Insurance contract or identification number398477G
    Number of Individuals Covered2875
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $448,856
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 16
    Insurance contract or identification number398477G
    Number of Individuals Covered2881
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $100,431
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract numberC366A-B
    Policy instance 1
    Insurance contract or identification numberC366A-B
    Number of Individuals Covered36
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $22,079
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 17
    Insurance contract or identification number398477G
    Number of Individuals Covered1523
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $43,246
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 18
    Insurance contract or identification number398477G
    Number of Individuals Covered1025
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $278,211
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 19
    Insurance contract or identification number398477G
    Number of Individuals Covered943
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $68,042
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number08868
    Policy instance 20
    Insurance contract or identification number08868
    Number of Individuals Covered137
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,075,132
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 12
    Insurance contract or identification number7550001
    Number of Individuals Covered490
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $69,278
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 11
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered470
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $19,163
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $191,329
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $19,163
    Insurance broker organization code?3
    Insurance broker nameJOHN WYSONG
    SILVERSCRIPT (National Association of Insurance Commissioners NAIC id number: 52411 )
    Policy contract number10111
    Policy instance 10
    Insurance contract or identification number10111
    Number of Individuals Covered576
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $21,896
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees21896
    Insurance broker organization code?3
    Insurance broker nameGROUP ADMINISTRATIVE CONCEPTS
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1969
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $153,421
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered45
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $236,628
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered274
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $527,594
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 5
    Insurance contract or identification number01109420
    Number of Individuals Covered932
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $232,835
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 960314
    Policy instance 6
    Insurance contract or identification numberOK 960314
    Number of Individuals Covered1064
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $106,486
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 7
    Insurance contract or identification number28720
    Number of Individuals Covered105
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $11,246
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $105,423
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $11,246
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract numberC30551
    Policy instance 8
    Insurance contract or identification numberC30551
    Number of Individuals Covered222
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $13,246
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedINDIVIDUAL CANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $132,461
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,246
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 9
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered576
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,044,608
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 9
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered575
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $986,027
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 17
    Insurance contract or identification number398477G
    Number of Individuals Covered1733
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $45,804
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1951
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $150,436
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered42
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $193,943
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 960314
    Policy instance 6
    Insurance contract or identification numberOK 960314
    Number of Individuals Covered1075
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $105,482
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 7
    Insurance contract or identification number28720
    Number of Individuals Covered112
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $11,834
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $118,344
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract number
    Policy instance 8
    Number of Individuals Covered328
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $13,279
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedINDIVIDUAL CANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $132,791
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SILVERSCRIPT (National Association of Insurance Commissioners NAIC id number: 52411 )
    Policy contract number10111
    Policy instance 10
    Insurance contract or identification number10111
    Number of Individuals Covered542
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $25,741
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Welfare Benefit Premiums Paid to CarrierUSD $960,948
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 11
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered464
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $16,445
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $164,548
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number7550001
    Policy instance 12
    Insurance contract or identification number7550001
    Number of Individuals Covered470
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $70,492
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 13
    Insurance contract or identification numberABL960599
    Number of Individuals Covered2832
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $18,667
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 14
    Number of Individuals Covered326
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $19,777
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $98,887
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 15
    Insurance contract or identification number398477G
    Number of Individuals Covered2992
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $472,505
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 16
    Insurance contract or identification number398477G
    Number of Individuals Covered3000
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $102,559
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 18
    Insurance contract or identification number398477G
    Number of Individuals Covered933
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $287,154
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 19
    Insurance contract or identification number398477G
    Number of Individuals Covered846
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $70,470
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number08868
    Policy instance 20
    Insurance contract or identification number08868
    Number of Individuals Covered151
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,210,600
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 5
    Insurance contract or identification number01109420
    Number of Individuals Covered899
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $184,715
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract numberC366A-B
    Policy instance 1
    Insurance contract or identification numberC366A-B
    Number of Individuals Covered55
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $31,470
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered304
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $548,900
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number10771-1004
    Policy instance 2
    Insurance contract or identification number10771-1004
    Number of Individuals Covered1885
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $150,174
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 17
    Insurance contract or identification number398477G
    Number of Individuals Covered2991
    Insurance policy start date2010-07-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $130,870
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 19
    Insurance contract or identification number398477G
    Number of Individuals Covered1674
    Insurance policy start date2010-07-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $12,755
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 20
    Insurance contract or identification number398477G
    Number of Individuals Covered933
    Insurance policy start date2010-07-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $74,210
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberABL960599
    Policy instance 15
    Insurance contract or identification numberABL960599
    Number of Individuals Covered1081
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $79,184
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
    Policy contract numberC366A
    Policy instance 1
    Insurance contract or identification numberC366A
    Number of Individuals Covered53
    Insurance policy start date2010-01-01
    Insurance policy end date2010-09-30
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $29,731
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Insurance broker organization code?3
    Insurance broker nameASSOCIATION & SOCIETY INSURANCE COR
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number08868
    Policy instance 22
    Insurance contract or identification number08868
    Number of Individuals Covered178
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $2,145,447
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018051
    Policy instance 4
    Insurance contract or identification number018051
    Number of Individuals Covered164
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $489,874
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
    Policy contract number08112
    Policy instance 3
    Insurance contract or identification number08112
    Number of Individuals Covered41
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $165,663
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 21
    Insurance contract or identification number398477G
    Number of Individuals Covered835
    Insurance policy start date2010-07-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $17,878
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number
    Policy instance 16
    Number of Individuals Covered137
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $16,396
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP CANCER INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $81,978
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $16,396
    Insurance broker organization code?3
    Insurance broker nameOLDHAM WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract number398477G
    Policy instance 18
    Insurance contract or identification number398477G
    Number of Individuals Covered2999
    Insurance policy start date2010-07-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $29,729
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameAON CONSULTING INC
    LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
    Policy contract numberOK 960314
    Policy instance 7
    Insurance contract or identification numberOK 960314
    Number of Individuals Covered1081
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedACCIDENTAL DEATH
    Welfare Benefit Premiums Paid to CarrierUSD $94,711
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
    Policy contract number012180
    Policy instance 6
    Insurance contract or identification number012180
    Number of Individuals Covered3027
    Insurance policy start date2010-01-01
    Insurance policy end date2010-06-30
    Total amount of commissions paid to insurance brokerUSD $10,784
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Life Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $922,987
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,784
    Insurance broker organization code?3
    Insurance broker nameEICHLITZ DENNIS WRAY & WESTHEIMER A
    NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
    Policy contract number
    Policy instance 9
    Number of Individuals Covered193
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $16,985
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedINDIVIDUAL CANCER COVERAGE
    Welfare Benefit Premiums Paid to CarrierUSD $147,116
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $16,985
    Insurance broker organization code?3
    Insurance broker nameOLDHAM WEEKS
    HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
    Policy contract numberAGP003790
    Policy instance 10
    Insurance contract or identification numberAGP003790
    Number of Individuals Covered511
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,038,609
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SILVERSCRIPT (National Association of Insurance Commissioners NAIC id number: 52411 )
    Policy contract number10111
    Policy instance 11
    Insurance contract or identification number10111
    Number of Individuals Covered512
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $30,228
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Welfare Benefit Premiums Paid to CarrierUSD $1,009,542
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Amount paid for insurance broker fees30228
    Additional information about fees paid to insurance brokerADMIN FEES
    Insurance broker organization code?3
    Insurance broker nameGROUP ADMINISTRATIVE CONCEPTS
    UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
    Policy contract number844001-000, 099
    Policy instance 12
    Insurance contract or identification number844001-000, 099
    Number of Individuals Covered446
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $15,396
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $154,912
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $15,396
    Insurance broker organization code?3
    Insurance broker nameJOHN WYSONG
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number01109420
    Policy instance 5
    Insurance contract or identification number01109420
    Number of Individuals Covered874
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $183,236
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 )
    Policy contract numberC366A-B
    Policy instance 13
    Insurance contract or identification numberC366A-B
    Number of Individuals Covered53
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $9,516
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $0
    Insurance broker organization code?3
    Insurance broker nameASSOCIATION & SOCIETY INSURANCE COR
    SIGNATURE AGENCY, INC. (National Association of Insurance Commissioners NAIC id number: N/A )
    Policy contract number7550001
    Policy instance 14
    Insurance contract or identification number7550001
    Number of Individuals Covered513
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedLEGAL CARE
    Welfare Benefit Premiums Paid to CarrierUSD $69,714
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
    Policy contract number28720
    Policy instance 8
    Insurance contract or identification number28720
    Number of Individuals Covered113
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $8,397
    Total amount of fees paid to insurance companyUSD $0
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Other welfare benefits providedGROUP LONG-TERM CARE INSURANCE
    Welfare Benefit Premiums Paid to CarrierUSD $83,972
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,397
    Insurance broker organization code?3
    Insurance broker nameWEEKS & ASSOCIATES

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