SAINT DAVID'S SCHOOL has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WELFARE PLAN OF SAINT DAVID'S SCHOOL
| Measure | Date | Value |
|---|
| 2022: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 214 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 214 |
| 2021: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 206 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 206 |
| 2020: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 136 |
| Total of all active and inactive participants | 2020-07-01 | 136 |
| Total participants | 2020-07-01 | 136 |
| Number of participants with account balances | 2020-07-01 | 136 |
| 2019: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 196 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 185 |
| Total of all active and inactive participants | 2019-07-01 | 185 |
| Total participants | 2019-07-01 | 185 |
| Number of participants with account balances | 2019-07-01 | 185 |
| 2018: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 196 |
| Total of all active and inactive participants | 2018-07-01 | 196 |
| Total participants | 2018-07-01 | 196 |
| 2017: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 190 |
| Total of all active and inactive participants | 2017-07-01 | 190 |
| Total participants | 2017-07-01 | 190 |
| 2016: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 182 |
| Total of all active and inactive participants | 2016-07-01 | 182 |
| 2015: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 197 |
| Total of all active and inactive participants | 2015-07-01 | 197 |
| 2014: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 187 |
| Total of all active and inactive participants | 2014-07-01 | 187 |
| 2013: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 170 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 173 |
| Total of all active and inactive participants | 2013-07-01 | 173 |
| 2012: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 170 |
| Total of all active and inactive participants | 2012-07-01 | 170 |
| 2011: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 174 |
| Total of all active and inactive participants | 2011-07-01 | 174 |
| 2022: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Submission has been amended | No |
| 2022-07-01 | This submission is the final filing | No |
| 2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-07-01 | Plan is a collectively bargained plan | No |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Submission has been amended | No |
| 2021-07-01 | This submission is the final filing | No |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-07-01 | Plan is a collectively bargained plan | No |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | Yes |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Submission has been amended | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: WELFARE PLAN OF SAINT DAVID'S SCHOOL 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 2 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $15,554 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $111,807 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,554 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0270005 |
| Policy instance | 1 |
| Insurance contract or identification number | 0270005 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $101,397 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,534,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $101,397 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 2 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $10,562 | | Total amount of fees paid to insurance company | USD $1,675 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $88,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,562 | | Amount paid for insurance broker fees | 1675 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0270005 |
| Policy instance | 1 |
| Insurance contract or identification number | 0270005 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $94,539 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,363,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $94,539 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0270005 |
| Policy instance | 1 |
| Insurance contract or identification number | 0270005 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $92,026 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,271,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $92,026 | | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 2 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $11,334 | | Total amount of fees paid to insurance company | USD $1,113 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $81,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,334 | | Amount paid for insurance broker fees | 1113 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 2 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $89,478 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,222,256 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $89,478 | | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICE, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 1 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $10,842 | | Total amount of fees paid to insurance company | USD $1,047 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $91,098 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,842 | | Amount paid for insurance broker fees | 1047 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 871459G |
| Policy instance | 3 |
| Insurance contract or identification number | 871459G | | Number of Individuals Covered | 116 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $6 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 2 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2019-01-01 | | Total amount of commissions paid to insurance broker | USD $8,059 | | Total amount of fees paid to insurance company | USD $891 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $66,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,059 | | Amount paid for insurance broker fees | 891 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 1 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $95,793 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,224,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $95,793 | | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 871459G |
| Policy instance | 3 |
| Insurance contract or identification number | 871459G | | Number of Individuals Covered | 116 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $2,987 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,987 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 2 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $5,059 | | Total amount of fees paid to insurance company | USD $747 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $64,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,059 | | Amount paid for insurance broker fees | 747 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 1 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $71,921 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,956,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,921 | | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 1 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $4,444 | | Total amount of fees paid to insurance company | USD $631 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,454 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,444 | | Amount paid for insurance broker fees | 631 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker name | AUSTIN & CO INC |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 2 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $57,630 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,440,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,630 | | Insurance broker name | AUSTIN & CO INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 871459G |
| Policy instance | 3 |
| Insurance contract or identification number | 871459G | | Number of Individuals Covered | 104 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,487 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,487 | | Insurance broker name | AUSTIN & CO INC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 871459G |
| Policy instance | 3 |
| Insurance contract or identification number | 871459G | | Number of Individuals Covered | 104 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,474 | | Total amount of fees paid to insurance company | USD $64 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,474 | | Amount paid for insurance broker fees | 64 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker name | AUSTIN & CO INC |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 2 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $55,033 | | Total amount of fees paid to insurance company | USD $2,602 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,364,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,033 | | Amount paid for insurance broker fees | 2602 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker name | AUSTIN & CO INC |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 461805 |
| Policy instance | 1 |
| Insurance contract or identification number | 461805 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $4,245 | | Total amount of fees paid to insurance company | USD $601 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,059 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,245 | | Amount paid for insurance broker fees | 601 | | Additional information about fees paid to insurance broker | OVERHEAD EXPENSES | | Insurance broker name | AUSTIN & CO INC |
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| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 871459G |
| Policy instance | 2 |
| Insurance contract or identification number | 871459G | | Number of Individuals Covered | 105 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $2,401 | | Total amount of fees paid to insurance company | USD $410 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,401 | | Amount paid for insurance broker fees | 410 | | Insurance broker name | AUSTIN & CO INC |
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| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | SD08501 |
| Policy instance | 1 |
| Insurance contract or identification number | SD08501 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $55,595 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,372,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,595 | | Insurance broker name | AUSTIN & CO INC |
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