RHODE ISLAND TEXTILE COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN
401k plan membership statisitcs for RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2018: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-08-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-08-01 | 75 |
| Total of all active and inactive participants | 2018-08-01 | 75 |
| Total participants | 2018-08-01 | 75 |
| 2017: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-08-01 | 0 |
| Total of all active and inactive participants | 2017-08-01 | 0 |
| Total participants | 2017-08-01 | 0 |
| 2016: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-08-01 | 0 |
| Total of all active and inactive participants | 2016-08-01 | 0 |
| Total participants | 2016-08-01 | 0 |
| 2015: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-08-01 | 0 |
| Total of all active and inactive participants | 2015-08-01 | 0 |
| Total participants | 2015-08-01 | 0 |
| 2014: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-08-01 | 0 |
| Total of all active and inactive participants | 2014-08-01 | 0 |
| Total participants | 2014-08-01 | 0 |
| 2013: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-08-01 | 0 |
| Total of all active and inactive participants | 2013-08-01 | 0 |
| Total participants | 2013-08-01 | 0 |
| 2012: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-08-01 | 279 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-08-01 | 224 |
| Total of all active and inactive participants | 2012-08-01 | 224 |
| Total participants | 2012-08-01 | 0 |
| 2011: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-08-01 | 297 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-08-01 | 279 |
| Total of all active and inactive participants | 2011-08-01 | 279 |
| Total participants | 2011-08-01 | 279 |
| 2010: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-08-01 | 322 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-08-01 | 297 |
| Total of all active and inactive participants | 2010-08-01 | 297 |
| Total participants | 2010-08-01 | 297 |
| 2009: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-08-01 | 397 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-08-01 | 322 |
| Total of all active and inactive participants | 2009-08-01 | 322 |
| Measure | Date | Value |
|---|
| 2013 : RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2013 401k financial data |
|---|
| Value of total assets at end of year | 2013-07-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-07-31 | No |
| Was this plan covered by a fidelity bond | 2013-07-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-07-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-07-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-07-31 | No |
| Value of interest in common/collective trusts at end of year | 2013-07-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-07-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-07-31 | No |
| Did the plan have assets held for investment | 2013-07-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-07-31 | No |
| 2018: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-08-01 | Type of plan entity | Single employer plan |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-08-01 | Type of plan entity | Single employer plan |
| 2016-08-01 | Plan funding arrangement – Insurance | Yes |
| 2016-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2014 form 5500 responses |
|---|
| 2014-08-01 | Type of plan entity | Single employer plan |
| 2014-08-01 | Plan funding arrangement – Insurance | Yes |
| 2014-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2013 form 5500 responses |
|---|
| 2013-08-01 | Type of plan entity | Single employer plan |
| 2013-08-01 | Plan funding arrangement – Insurance | Yes |
| 2013-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2012 form 5500 responses |
|---|
| 2012-08-01 | Type of plan entity | Single employer plan |
| 2012-08-01 | Submission has been amended | Yes |
| 2012-08-01 | Plan funding arrangement – Insurance | Yes |
| 2012-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2011 form 5500 responses |
|---|
| 2011-08-01 | Type of plan entity | Single employer plan |
| 2011-08-01 | Plan funding arrangement – Insurance | Yes |
| 2011-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2010 form 5500 responses |
|---|
| 2010-08-01 | Type of plan entity | Single employer plan |
| 2010-08-01 | Plan funding arrangement – Insurance | Yes |
| 2010-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: RHODE ISLAND TEXTILE COMPANY FLEXIBLE BENEFITS PLAN 2009 form 5500 responses |
|---|
| 2009-08-01 | Type of plan entity | Single employer plan |
| 2009-08-01 | Plan funding arrangement – Insurance | Yes |
| 2009-08-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0906088 |
| Policy instance | 3 |
| Insurance contract or identification number | 0906088 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of fees paid to insurance company | USD $12,338 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 12338 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| LONDON HEALTH ADMINISTRATORS, LTD. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 75 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of fees paid to insurance company | USD $4,879 | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | Yes | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4879 | | Additional information about fees paid to insurance broker | FEES FOR THIRD PARTY ADMINISTRATION | | Insurance broker organization code? | 5 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G00097D2 |
| Policy instance | 2 |
| Insurance contract or identification number | G00097D2 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $3,238 | | Total amount of fees paid to insurance company | USD $1,493 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,238 | | Amount paid for insurance broker fees | 1493 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| LONDON HEALTH ADMINISTRATORS, LTD. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 128 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of fees paid to insurance company | USD $7,142 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 3 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $5,171 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | 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 number | 0906088 |
| Policy instance | 1 |
| Insurance contract or identification number | 0906088 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $23,684 | | Health Insurance Welfare Benefit | Yes | | 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 number | 906088 |
| Policy instance | 1 |
| Insurance contract or identification number | 906088 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2015-10-01 | | Insurance policy end date | 2016-09-30 | | Total amount of fees paid to insurance company | USD $23,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 23045 | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY INC |
|
| LONDON HEALTH ADMINISTRATORS, LTD. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 125 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-07-31 | | Total amount of commissions paid to insurance broker | USD $8,248 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,248 | | Insurance broker organization code? | 5 | | Insurance broker name | LONDON HEALTH ADMINISTRATORS, LTD. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 3 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-07-31 | | Total amount of commissions paid to insurance broker | USD $1,237 | | Total amount of fees paid to insurance company | USD $259 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $12,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,237 | | Amount paid for insurance broker fees | 259 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY |
|
| BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 ) |
| Policy contract number | 101787 |
| Policy instance | 1 |
| Insurance contract or identification number | 101787 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $17,936 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,936 | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY INC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 3 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $1,272 | | Total amount of fees paid to insurance company | USD $287 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $12,715 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,272 | | Amount paid for insurance broker fees | 287 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY |
|
| LONDON HEALTH ADMINISTRATORS, LTD. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 126 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of fees paid to insurance company | USD $6,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6513 | | Insurance broker organization code? | 5 | | Insurance broker name | LONDON HEALTH ADMINISTRATORS, LTD. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 3 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $1,333 | | Total amount of fees paid to insurance company | USD $327 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $13,334 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,333 | | Amount paid for insurance broker fees | 327 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY |
|
| LONDON HEALTH ADMINISTRATORS, LTD. (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 171 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of fees paid to insurance company | USD $6,724 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6724 | | Insurance broker organization code? | 5 | | Insurance broker name | LONDON HEALTH ADMINISTRATORS, LTD. |
|
| BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 ) |
| Policy contract number | 101787 |
| Policy instance | 1 |
| Insurance contract or identification number | 101787 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $19,211 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,211 | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY INC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 1 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 241 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $1,511 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $15,114 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,511 | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY |
|
| BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 ) |
| Policy contract number | 101787 000 |
| Policy instance | 3 |
| Insurance contract or identification number | 101787 000 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of commissions paid to insurance broker | USD $19,865 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,865 | | Insurance broker organization code? | 3 | | Insurance broker name | STARKWEATHER & SHEPLEY INC |
|
| PRIMARILY CARE (National Association of Insurance Commissioners NAIC id number: 5242 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 151 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-07-31 | | Total amount of fees paid to insurance company | USD $19,080 | | Other welfare benefits provided | SELF FUNDED HEALTH | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2964 | | Insurance broker organization code? | 3 | | Insurance broker name | PRIMARILY CARE INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 1 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $1,546 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $15,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIMARILY CARE (National Association of Insurance Commissioners NAIC id number: 5242 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 172 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $17,968 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 ) |
| Policy contract number | 101787 0 |
| Policy instance | 3 |
| Insurance contract or identification number | 101787 0 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-07-31 | | Total amount of commissions paid to insurance broker | USD $22,886 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 ) |
| Policy contract number | 101787 1 |
| Policy instance | 3 |
| Insurance contract or identification number | 101787 1 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $28,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRIMARILY CARE (National Association of Insurance Commissioners NAIC id number: 5242 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 183 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $19,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUGO97D2 |
| Policy instance | 1 |
| Insurance contract or identification number | GLUGO97D2 | | Number of Individuals Covered | 305 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $1,561 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $15,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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