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RED RIVER BANK EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameRED RIVER BANK EMPLOYEE BENEFIT PLAN
Plan identification number 501

RED RIVER BANK EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

RED RIVER BANK has sponsored the creation of one or more 401k plans.

Company Name:RED RIVER BANK
Employer identification number (EIN):721426574
NAIC Classification:522110
NAIC Description:Commercial Banking

Additional information about RED RIVER BANK

Jurisdiction of Incorporation: Louisiana Secretary Of State, Commercial Division
Incorporation Date:
Company Identification Number: 34742202B

More information about RED RIVER BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RED RIVER BANK EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01ANDREW CUTRER
5012015-10-01ANDREW CUTRER
5012014-10-01ANDREW CUTRER
5012013-10-01ANDREW CUTRER
5012012-10-01ANDREW CUTRER
5012011-10-01ANDREW CUTRER
5012009-10-01ANDREW CUTRER
5012008-10-01

Plan Statistics for RED RIVER BANK EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for RED RIVER BANK EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01262
Total number of active participants reported on line 7a of the Form 55002022-10-01260
Total of all active and inactive participants2022-10-01260
2021: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01262
Total number of active participants reported on line 7a of the Form 55002021-10-01262
Total of all active and inactive participants2021-10-01262
2020: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01258
Total number of active participants reported on line 7a of the Form 55002020-10-01262
Total of all active and inactive participants2020-10-01262
2019: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01241
Total number of active participants reported on line 7a of the Form 55002019-10-01258
Total of all active and inactive participants2019-10-01258
2018: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01229
Total number of active participants reported on line 7a of the Form 55002018-10-01241
Total of all active and inactive participants2018-10-01241
2017: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01216
Total number of active participants reported on line 7a of the Form 55002017-10-01229
Total of all active and inactive participants2017-10-01229
2016: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01200
Total number of active participants reported on line 7a of the Form 55002016-10-01216
Total of all active and inactive participants2016-10-01216
2015: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01198
Total number of active participants reported on line 7a of the Form 55002015-10-01200
Total of all active and inactive participants2015-10-01200
2014: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01202
Total number of active participants reported on line 7a of the Form 55002014-10-01198
Total of all active and inactive participants2014-10-01198
2013: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01193
Total number of active participants reported on line 7a of the Form 55002013-10-01202
Total of all active and inactive participants2013-10-01202
2012: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01171
Total number of active participants reported on line 7a of the Form 55002012-10-01193
Total of all active and inactive participants2012-10-01193
2011: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01214
Total number of active participants reported on line 7a of the Form 55002011-10-01171
Total of all active and inactive participants2011-10-01171
2009: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01156
Total number of active participants reported on line 7a of the Form 55002009-10-01202
Total of all active and inactive participants2009-10-01202

Form 5500 Responses for RED RIVER BANK EMPLOYEE BENEFIT PLAN

2022: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01This submission is the final filingNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes
2008: RED RIVER BANK EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 6
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered260
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $6,224
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $24,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,224
Insurance broker organization code?5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered260
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $3,261
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $58,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,261
Insurance broker organization code?5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 4
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered260
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $34,155
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $186,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,155
Insurance broker organization code?5
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered260
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $103,504
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $690,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103,504
Insurance broker organization code?5
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered260
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $7,880
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $35,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,880
Insurance broker organization code?5
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $6,340
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $34,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,340
Insurance broker organization code?5
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $90,109
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,109
Insurance broker organization code?5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 4
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $30,627
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $176,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,627
Insurance broker organization code?5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,711
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $66,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,711
Insurance broker organization code?5
VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 6
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $7,925
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $23,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,925
Insurance broker organization code?5
VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 6
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $7,690
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $23,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,690
Insurance broker organization code?5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $70,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 4
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $36,445
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $178,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,445
Insurance broker organization code?5
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $91,476
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $609,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91,476
Insurance broker organization code?5
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered262
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $6,148
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $33,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,148
Insurance broker organization code?5
VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 7
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $7,558
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $21,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,558
Insurance broker organization code?5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 6
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,404
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $66,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,404
Insurance broker organization code?5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $35,258
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $201,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,258
Insurance broker organization code?5
AMERICAN HEALTH HOLDINGS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 3
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,266
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedPRECERTIFICATION
Welfare Benefit Premiums Paid to CarrierUSD $3,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,266
Insurance broker organization code?5
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $90,560
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $603,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,560
Insurance broker organization code?5
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered258
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $6,046
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $31,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,046
Insurance broker organization code?5
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $5,662
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $22,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,662
Insurance broker organization code?5
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $94,869
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $632,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $94,869
Insurance broker organization code?5
AMERICAN HEALTH HOLDINGS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 3
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $4,360
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedPRECERTIFICATION
Welfare Benefit Premiums Paid to CarrierUSD $11,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,360
Insurance broker organization code?5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $69,138
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $189,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69,138
Insurance broker organization code?5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 6
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $74,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 7
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered241
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $7,078
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $18,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,078
Insurance broker organization code?5
VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 8
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2018-01-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $7,095
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $15,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract numberNOT AVAILABLE
Policy instance 7
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $5,177
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $73,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberNOT AVAILABLE
Policy instance 5
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $35,884
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE
Welfare Benefit Premiums Paid to CarrierUSD $179,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN HEALTH HOLDINGS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 3
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $3,638
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedPRECERTIFICATION
Welfare Benefit Premiums Paid to CarrierUSD $10,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 2
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $104,959
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $699,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberNOT AVAILABLE
Policy instance 1
Insurance contract or identification numberNOT AVAILABLE
Number of Individuals Covered229
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,695
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $18,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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