DUTTON-LAINSON COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY
401k plan membership statisitcs for EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY
| Measure | Date | Value |
|---|
| 2022: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-10-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 202 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 202 |
| 2021: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 211 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 212 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 212 |
| 2020: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 220 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 211 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 211 |
| 2019: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 218 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 2 |
| Total of all active and inactive participants | 2019-10-01 | 220 |
| 2018: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 227 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 227 |
| 2017: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 227 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 228 |
| 2016: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 221 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 222 |
| 2015: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 213 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 3 |
| Total of all active and inactive participants | 2015-10-01 | 217 |
| 2014: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 215 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 220 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 2 |
| Total of all active and inactive participants | 2014-10-01 | 222 |
| 2013: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 220 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 215 |
| Number of retired or separated participants receiving benefits | 2013-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
| Total of all active and inactive participants | 2013-10-01 | 215 |
| 2012: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 219 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 220 |
| 2011: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 204 |
| Total of all active and inactive participants | 2011-10-01 | 204 |
| 2010: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 173 |
| Number of retired or separated participants receiving benefits | 2010-10-01 | 0 |
| Total of all active and inactive participants | 2010-10-01 | 173 |
| 2009: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 173 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 4 |
| Total of all active and inactive participants | 2009-10-01 | 177 |
| 2022: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2022 form 5500 responses |
|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: EMPLOYEE WELFARE BENEFIT PLAN OF DUTTON-LAINSON COMPANY 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Submission has been amended | Yes |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 072690G |
| Policy instance | 4 |
| Insurance contract or identification number | 072690G | | Number of Individuals Covered | 212 | | Insurance policy start date | 2023-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 56 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $2,750 | | Total amount of fees paid to insurance company | USD $830 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,750 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 830 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 973 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $10,620 | | Total amount of fees paid to insurance company | USD $3,238 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $70,800 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,620 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 101929 |
| Policy instance | 1 |
| Insurance contract or identification number | 101929 | | Number of Individuals Covered | 411 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 57 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $2,580 | | Total amount of fees paid to insurance company | USD $523 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,580 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 523 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 963 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $11,019 | | Total amount of fees paid to insurance company | USD $2,266 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $73,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,019 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 101929 |
| Policy instance | 1 |
| Insurance contract or identification number | 101929 | | Number of Individuals Covered | 428 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 56 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $2,538 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,917 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,111 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 1045 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $11,533 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $76,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,610 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 101929 |
| Policy instance | 1 |
| Insurance contract or identification number | 101929 | | Number of Individuals Covered | 452 | | 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 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 56 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $2,570 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,570 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 1005 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $11,181 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $74,540 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,181 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 101929 |
| Policy instance | 1 |
| Insurance contract or identification number | 101929 | | Number of Individuals Covered | 458 | | 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 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 61 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $2,670 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,799 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,670 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 1049 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $10,699 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $71,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,699 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 300115 |
| Policy instance | 1 |
| Insurance contract or identification number | 300115 | | Number of Individuals Covered | 485 | | Insurance policy start date | 2018-01-01 | | 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 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 692548GLT |
| Policy instance | 3 |
| Insurance contract or identification number | 692548GLT | | Number of Individuals Covered | 59 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $2,856 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 6925480GL |
| Policy instance | 2 |
| Insurance contract or identification number | 6925480GL | | Number of Individuals Covered | 1016 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $11,362 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $75,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) |
| Policy contract number | 300115 |
| Policy instance | 1 |
| Insurance contract or identification number | 300115 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
