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ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 401k Plan overview

Plan NameASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE
Plan identification number 509

ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

ASSOCIATION OF AMERICAN MEDICAL COLLEGES has sponsored the creation of one or more 401k plans.

Company Name:ASSOCIATION OF AMERICAN MEDICAL COLLEGES
Employer identification number (EIN):362169124
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2008-02-04
Company Identification Number: 0800933107
Legal Registered Office Address: 655 K ST NW STE 100

WASHINGTON
United States of America (USA)
20001

More information about ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092018-01-01BERNARD K. JARVIS2019-09-26
5092017-01-01
5092016-01-01BERNARD JARVIS
5092015-01-01BERNARD JARVIS
5092014-01-01BERNARD JARVIS
5092013-01-01BERNARD K. JARVIS
5092012-01-01AMANDA NEAL
5092011-01-01EILEEN STOKES
5092010-01-01EILEEN STOKES
5092009-01-01DONNA WHITLOCK STEWART

Plan Statistics for ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE

401k plan membership statisitcs for ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE

Measure Date Value
2018: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-01538
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
Number of employers contributing to the scheme2018-01-010
2017: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-01726
Total number of active participants reported on line 7a of the Form 55002017-01-01538
Number of retired or separated participants receiving benefits2017-01-014
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01542
2016: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01649
Total number of active participants reported on line 7a of the Form 55002016-01-01720
Number of retired or separated participants receiving benefits2016-01-016
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01726
2015: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01639
Total number of active participants reported on line 7a of the Form 55002015-01-01616
Number of retired or separated participants receiving benefits2015-01-018
Number of other retired or separated participants entitled to future benefits2015-01-0125
Total of all active and inactive participants2015-01-01649
2014: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01453
Total number of active participants reported on line 7a of the Form 55002014-01-01584
Number of retired or separated participants receiving benefits2014-01-0125
Number of other retired or separated participants entitled to future benefits2014-01-0130
Total of all active and inactive participants2014-01-01639
2013: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01453
Total number of active participants reported on line 7a of the Form 55002013-01-01572
Number of retired or separated participants receiving benefits2013-01-0129
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01601
2012: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01562
Total number of active participants reported on line 7a of the Form 55002012-01-01427
Number of retired or separated participants receiving benefits2012-01-0126
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01453
2011: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01485
Total number of active participants reported on line 7a of the Form 55002011-01-01530
Number of retired or separated participants receiving benefits2011-01-0124
Number of other retired or separated participants entitled to future benefits2011-01-018
Total of all active and inactive participants2011-01-01562
2010: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-01494
Total number of active participants reported on line 7a of the Form 55002010-01-01485
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01485
2009: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01411
Total number of active participants reported on line 7a of the Form 55002009-01-01494
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01494

Form 5500 Responses for ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE

2018: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ASSOCIATION OF AMERICAN MEDICAL COLLEGES HEALTH INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number67092
Policy instance 1
Insurance contract or identification number67092
Number of Individuals Covered834
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $197,608
Total amount of fees paid to insurance companyUSD $21,210
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,695,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197,608
Amount paid for insurance broker fees21210
Additional information about fees paid to insurance brokerNON-MONETARY INCENTIVE WHOLESALER FEE
Insurance broker organization code?3
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number67092
Policy instance 1
Insurance contract or identification number67092
Number of Individuals Covered843
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $219,888
Total amount of fees paid to insurance companyUSD $84,182
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,282,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $219,888
Amount paid for insurance broker fees65149
Additional information about fees paid to insurance brokerNEW BUSINESS BONUS NON-MONETARY INCENTIVE AMROUNT
Insurance broker organization code?3
Insurance broker namePOTOMAC BASIC GROUP ASSOCIATION
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered694
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
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,879,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,918
Insurance broker organization code?3
Insurance broker nameASSOCIATION MUTUAL HEALTH INS. CO.
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number0XAP
Policy instance 1
Insurance contract or identification number0XAP
Number of Individuals Covered202
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $34,719
Total amount of fees paid to insurance companyUSD $15,884
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $991,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,719
Amount paid for insurance broker fees7111
Additional information about fees paid to insurance brokerMEDICAL CONTRACTS NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS. GROUP
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberOXAP
Policy instance 1
Insurance contract or identification numberOXAP
Number of Individuals Covered285
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $38,289
Total amount of fees paid to insurance companyUSD $23,537
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,093,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,289
Amount paid for insurance broker fees13093
Additional information about fees paid to insurance brokerMEDICAL CONTRACTS NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS. GROUP
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered641
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $54,268
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,430,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $54,268
Insurance broker organization code?3
Insurance broker nameASSOCIATION MUTUAL HEALTH INS. CO.
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered1262
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $58,251
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,095,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $58,251
Insurance broker organization code?3
Insurance broker nameASSOCIATION MUTUAL HEALTH INS. CO.
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberOXAP
Policy instance 1
Insurance contract or identification numberOXAP
Number of Individuals Covered135
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $40,521
Total amount of fees paid to insurance companyUSD $22,587
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,157,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,521
Amount paid for insurance broker fees12845
Additional information about fees paid to insurance brokerMEDICAL CONTRACTS NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS. GROUP
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered1224
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $53,809
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $3,765,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,809
Insurance broker organization code?3
Insurance broker nameASSOCIATION MUTUAL HEALTH INS. CO.
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberOXAP
Policy instance 1
Insurance contract or identification numberOXAP
Number of Individuals Covered133
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $38,671
Total amount of fees paid to insurance companyUSD $22,004
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $1,104,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,671
Amount paid for insurance broker fees11778
Additional information about fees paid to insurance brokerFEES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS. GROUP
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberOXAP
Policy instance 1
Insurance contract or identification numberOXAP
Number of Individuals Covered102
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $47,005
Total amount of fees paid to insurance companyUSD $17,988
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $940,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered698
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $54,210
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $3,595,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberOXAP
Policy instance 1
Insurance contract or identification numberOXAP
Number of Individuals Covered90
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $40,484
Total amount of fees paid to insurance companyUSD $15,849
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $809,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,484
Amount paid for insurance broker fees7120
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS. GROUP
ASSOCIATION MUTUAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28MC
Policy instance 2
Insurance contract or identification number28MC
Number of Individuals Covered459
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $47,862
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $3,506,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $47,862
Insurance broker organization code?3
Insurance broker nameASSOCIATION MUTUAL HEALTH INS. CO.

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