THAMES SHIPYARD & REPAIR CO. INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THAMES SHIPYARD HEALTH & LIFE PLAN
| Measure | Date | Value |
|---|
| 2022: THAMES SHIPYARD HEALTH & LIFE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 239 |
| Number of retired or separated participants receiving benefits | 2022-02-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
| Total of all active and inactive participants | 2022-02-01 | 241 |
| 2021: THAMES SHIPYARD HEALTH & LIFE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 234 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 248 |
| Number of retired or separated participants receiving benefits | 2021-02-01 | 2 |
| Total of all active and inactive participants | 2021-02-01 | 250 |
| 2020: THAMES SHIPYARD HEALTH & LIFE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 259 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 226 |
| Number of retired or separated participants receiving benefits | 2020-02-01 | 2 |
| Total of all active and inactive participants | 2020-02-01 | 228 |
| 2019: THAMES SHIPYARD HEALTH & LIFE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 256 |
| Number of retired or separated participants receiving benefits | 2019-02-01 | 3 |
| Total of all active and inactive participants | 2019-02-01 | 259 |
| 2018: THAMES SHIPYARD HEALTH & LIFE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 271 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 251 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 3 |
| Total of all active and inactive participants | 2018-02-01 | 254 |
| 2017: THAMES SHIPYARD HEALTH & LIFE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 218 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 267 |
| Number of retired or separated participants receiving benefits | 2017-02-01 | 4 |
| Total of all active and inactive participants | 2017-02-01 | 271 |
| 2016: THAMES SHIPYARD HEALTH & LIFE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 215 |
| Number of retired or separated participants receiving benefits | 2016-02-01 | 3 |
| Total of all active and inactive participants | 2016-02-01 | 218 |
| 2015: THAMES SHIPYARD HEALTH & LIFE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 222 |
| Number of retired or separated participants receiving benefits | 2015-02-01 | 4 |
| Total of all active and inactive participants | 2015-02-01 | 226 |
| 2014: THAMES SHIPYARD HEALTH & LIFE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 218 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 205 |
| Number of retired or separated participants receiving benefits | 2014-02-01 | 4 |
| Total of all active and inactive participants | 2014-02-01 | 209 |
| 2013: THAMES SHIPYARD HEALTH & LIFE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-02-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 210 |
| Number of retired or separated participants receiving benefits | 2013-02-01 | 8 |
| Total of all active and inactive participants | 2013-02-01 | 218 |
| 2012: THAMES SHIPYARD HEALTH & LIFE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 205 |
| Number of retired or separated participants receiving benefits | 2012-02-01 | 4 |
| Total of all active and inactive participants | 2012-02-01 | 209 |
| 2011: THAMES SHIPYARD HEALTH & LIFE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 216 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 202 |
| Number of retired or separated participants receiving benefits | 2011-02-01 | 4 |
| Total of all active and inactive participants | 2011-02-01 | 206 |
| 2010: THAMES SHIPYARD HEALTH & LIFE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-02-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-02-01 | 212 |
| Number of retired or separated participants receiving benefits | 2010-02-01 | 4 |
| Total of all active and inactive participants | 2010-02-01 | 216 |
| 2009: THAMES SHIPYARD HEALTH & LIFE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-02-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 203 |
| Number of retired or separated participants receiving benefits | 2009-02-01 | 1 |
| Total of all active and inactive participants | 2009-02-01 | 204 |
| Total participants | 2009-02-01 | 204 |
| 2022: THAMES SHIPYARD HEALTH & LIFE PLAN 2022 form 5500 responses |
|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Submission has been amended | No |
| 2022-02-01 | This submission is the final filing | No |
| 2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-02-01 | Plan is a collectively bargained plan | No |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: THAMES SHIPYARD HEALTH & LIFE PLAN 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Submission has been amended | No |
| 2021-02-01 | This submission is the final filing | No |
| 2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-02-01 | Plan is a collectively bargained plan | No |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: THAMES SHIPYARD HEALTH & LIFE PLAN 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | No |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: THAMES SHIPYARD HEALTH & LIFE PLAN 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: THAMES SHIPYARD HEALTH & LIFE PLAN 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: THAMES SHIPYARD HEALTH & LIFE PLAN 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: THAMES SHIPYARD HEALTH & LIFE PLAN 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: THAMES SHIPYARD HEALTH & LIFE PLAN 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: THAMES SHIPYARD HEALTH & LIFE PLAN 2014 form 5500 responses |
|---|
| 2014-02-01 | Type of plan entity | Single employer plan |
| 2014-02-01 | Plan funding arrangement – Insurance | Yes |
| 2014-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: THAMES SHIPYARD HEALTH & LIFE PLAN 2013 form 5500 responses |
|---|
| 2013-02-01 | Type of plan entity | Single employer plan |
| 2013-02-01 | Plan funding arrangement – Insurance | Yes |
| 2013-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: THAMES SHIPYARD HEALTH & LIFE PLAN 2012 form 5500 responses |
|---|
| 2012-02-01 | Type of plan entity | Single employer plan |
| 2012-02-01 | Plan funding arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: THAMES SHIPYARD HEALTH & LIFE PLAN 2011 form 5500 responses |
|---|
| 2011-02-01 | Type of plan entity | Single employer plan |
| 2011-02-01 | Plan funding arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: THAMES SHIPYARD HEALTH & LIFE PLAN 2010 form 5500 responses |
|---|
| 2010-02-01 | Type of plan entity | Single employer plan |
| 2010-02-01 | Plan funding arrangement – Insurance | Yes |
| 2010-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: THAMES SHIPYARD HEALTH & LIFE PLAN 2009 form 5500 responses |
|---|
| 2009-02-01 | Type of plan entity | Single employer plan |
| 2009-02-01 | Submission has been amended | No |
| 2009-02-01 | This submission is the final filing | No |
| 2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-02-01 | Plan is a collectively bargained plan | No |
| 2009-02-01 | Plan funding arrangement – Insurance | Yes |
| 2009-02-01 | Plan benefit arrangement – Insurance | Yes |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,000 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, VOLUNTARY, SUPPLEMENTAL & DEPENDENT LIFE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $10,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,000 | | Insurance broker organization code? | 3 |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $493,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $976 | | Total amount of fees paid to insurance company | USD $298 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $9,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $976 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 298 | | Additional information about fees paid to insurance broker | FEES |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 465 | | 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 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $493,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $964 | | Total amount of fees paid to insurance company | USD $150 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $9,492 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $964 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 150 | | Additional information about fees paid to insurance broker | FEES |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 454 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $498,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $16,062 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $576,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,968 | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $1,064 | | Total amount of fees paid to insurance company | USD $276 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,064 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 276 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $920 | | Total amount of fees paid to insurance company | USD $458 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $920 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 458 |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $23,970 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $491,573 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,970 | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Insurance policy start date | 2016-03-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $784 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,560 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $784 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Insurance policy start date | 2016-03-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $27,500 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $464,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,500 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $27,500 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,332 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,500 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $437 | | 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 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,125 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $437 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $27,500 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,025 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,500 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF CT INC. |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $27,500 | | Total amount of fees paid to insurance company | USD $2,815 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $390,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,500 | | Amount paid for insurance broker fees | 2815 | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $829 | | 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 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $829 | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $1,024 | | 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 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,679 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,024 | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $27,629 | | Total amount of fees paid to insurance company | USD $2,806 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $352,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,629 | | Amount paid for insurance broker fees | 2806 | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $26,813 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,617 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $930 | | 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 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 066839 |
| Policy instance | 1 |
| Insurance contract or identification number | 066839 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2009-03-01 | | Insurance policy end date | 2010-02-28 | | Total amount of commissions paid to insurance broker | USD $22,115 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,115 | | Additional information about fees paid to insurance broker | BONUSES AND AWARDS FOR SALES ACTIVITY | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | CL2534 |
| Policy instance | 2 |
| Insurance contract or identification number | CL2534 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2009-04-01 | | Insurance policy end date | 2010-03-31 | | Total amount of commissions paid to insurance broker | USD $931 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $9,134 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $931 | | Insurance broker organization code? | 3 | | Insurance broker name | DILL, JOYCE & THRESHER INC |
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