DAVID J. FRANK LANDSCAPE CONTRACTING, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA
401k plan membership statisitcs for DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA
| Measure | Date | Value |
|---|
| 2023: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 88 |
| Total of all active and inactive participants | 2023-01-01 | 88 |
| 2022: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 92 |
| Total of all active and inactive participants | 2022-01-01 | 92 |
| 2021: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 97 |
| Total of all active and inactive participants | 2021-01-01 | 97 |
| 2020: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 65 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 103 |
| Total of all active and inactive participants | 2020-01-01 | 103 |
| 2019: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 65 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 65 |
| Total of all active and inactive participants | 2019-01-01 | 65 |
| 2018: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 66 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 65 |
| Total of all active and inactive participants | 2018-01-01 | 65 |
| 2017: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 71 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 66 |
| Total of all active and inactive participants | 2017-01-01 | 66 |
| 2016: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 71 |
| Total of all active and inactive participants | 2016-01-01 | 71 |
| 2015: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 91 |
| Total of all active and inactive participants | 2015-01-01 | 91 |
| 2014: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 98 |
| Total of all active and inactive participants | 2014-01-01 | 98 |
| 2013: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 90 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 91 |
| Total of all active and inactive participants | 2013-01-01 | 91 |
| 2012: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 90 |
| Total of all active and inactive participants | 2012-01-01 | 90 |
| 2011: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 98 |
| Total of all active and inactive participants | 2011-01-01 | 98 |
| 2010: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 107 |
| Total of all active and inactive participants | 2010-01-01 | 107 |
| 2009: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 142 |
| Total of all active and inactive participants | 2009-01-01 | 142 |
| 2023: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: DAVID J. FRANK LANDSCAPE CONTRACTING, INC. MEDICAL BENEFITS PLAN W/SECTION 105 HRA 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| WPS (National Association of Insurance Commissioners NAIC id number: 10159 ) |
| Policy contract number | WP104 |
| Policy instance | 1 |
| Insurance contract or identification number | WP104 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WPS (National Association of Insurance Commissioners NAIC id number: 10159 ) |
| Policy contract number | WP104 |
| Policy instance | 1 |
| Insurance contract or identification number | WP104 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10011612 |
| Policy instance | 1 |
| Insurance contract or identification number | 10011612 | | Number of Individuals Covered | 97 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10011612 |
| Policy instance | 1 |
| Insurance contract or identification number | 10011612 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10011612 |
| Policy instance | 1 |
| Insurance contract or identification number | 10011612 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
| Policy contract number | 42373 00000 |
| Policy instance | 2 |
| Insurance contract or identification number | 42373 00000 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $588 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,132 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $588 |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10011612 |
| Policy instance | 1 |
| Insurance contract or identification number | 10011612 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WPS HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 10159 ) |
| Policy contract number | 10010525 |
| Policy instance | 2 |
| Insurance contract or identification number | 10010525 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,234 | | Total amount of fees paid to insurance company | USD $0 | | 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 $6,234 | | Insurance broker name | MICHAEL J. KONZEN |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10004599 |
| Policy instance | 1 |
| Insurance contract or identification number | 10004599 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $10,471 | | Total amount of fees paid to insurance company | USD $0 | | 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 $10,471 | | Insurance broker name | MICHAEL J. KONZEN |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10004599 |
| Policy instance | 1 |
| Insurance contract or identification number | 10004599 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $10,389 | | Total amount of fees paid to insurance company | USD $0 | | 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 $10,389 | | Insurance broker name | EMPLOYERS BENEFIT GROUP LLC |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10004599 |
| Policy instance | 1 |
| Insurance contract or identification number | 10004599 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $9,620 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $9,620 | | Insurance broker name | EMPLOYERS BENEFIT GROUP LLC |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 10004599 |
| Policy instance | 1 |
| Insurance contract or identification number | 10004599 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $7,884 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $7,884 | | Insurance broker name | EMPLOYERS BENEFIT GROUP LLC |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 173492 |
| Policy instance | 1 |
| Insurance contract or identification number | 173492 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $9,531 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $9,531 | | Insurance broker name | EMPLOYERS BENEFIT GROUP LLC |
|
| WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 53139 ) |
| Policy contract number | 173492 |
| Policy instance | 2 |
| Insurance contract or identification number | 173492 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $8,690 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 687099 |
| Policy instance | 1 |
| Insurance contract or identification number | 687099 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,801 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,538 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 687099 |
| Policy instance | 1 |
| Insurance contract or identification number | 687099 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $9,283 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $379,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,283 | | Insurance broker organization code? | 3 | | Insurance broker name | |
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