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WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 401k Plan overview

Plan NameWHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS
Plan identification number 501

WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 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)

401k Sponsoring company profile

WHEELER CLINIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:WHEELER CLINIC, INC.
Employer identification number (EIN):060867065
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01SABRINA TROCCHI2023-11-17
5012021-07-01SABRINA TROCCHI2022-12-22
5012020-07-01SABRINA TROCCHI2021-11-02
5012019-07-01SABRINA TROCCHI2021-01-15 SABRINA TROCCHI2021-01-15
5012018-07-01SABRINA TROCCHI2020-01-17 SABRINA TROCCHI2020-01-17
5012017-07-01
5012016-07-01
5012015-07-01
5012014-07-01
5012013-07-01
5012012-07-01STEWART JOSLIN
5012011-07-01SUSAN WALKAMA
5012009-07-01SUSAN WALKAMA

Plan Statistics for WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS

401k plan membership statisitcs for WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS

Measure Date Value
2022: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2022 401k membership
Total participants, beginning-of-year2022-07-01710
Total number of active participants reported on line 7a of the Form 55002022-07-01702
Number of retired or separated participants receiving benefits2022-07-012
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01704
Number of employers contributing to the scheme2022-07-010
2021: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2021 401k membership
Total participants, beginning-of-year2021-07-01784
Total number of active participants reported on line 7a of the Form 55002021-07-01709
Number of retired or separated participants receiving benefits2021-07-011
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01710
Number of employers contributing to the scheme2021-07-010
2020: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2020 401k membership
Total participants, beginning-of-year2020-07-01777
Total number of active participants reported on line 7a of the Form 55002020-07-01781
Number of retired or separated participants receiving benefits2020-07-013
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01784
Number of employers contributing to the scheme2020-07-010
2019: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2019 401k membership
Total participants, beginning-of-year2019-07-01749
Total number of active participants reported on line 7a of the Form 55002019-07-01777
Total of all active and inactive participants2019-07-01777
Total participants2019-07-01777
2018: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2018 401k membership
Total participants, beginning-of-year2018-07-01758
Total number of active participants reported on line 7a of the Form 55002018-07-01749
Total of all active and inactive participants2018-07-01749
Total participants2018-07-01749
2017: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2017 401k membership
Total participants, beginning-of-year2017-07-01738
Total number of active participants reported on line 7a of the Form 55002017-07-01758
Total of all active and inactive participants2017-07-01758
2016: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2016 401k membership
Total participants, beginning-of-year2016-07-01739
Total number of active participants reported on line 7a of the Form 55002016-07-01738
Total of all active and inactive participants2016-07-01738
2015: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2015 401k membership
Total participants, beginning-of-year2015-07-01729
Total number of active participants reported on line 7a of the Form 55002015-07-01739
Total of all active and inactive participants2015-07-01739
2014: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2014 401k membership
Total participants, beginning-of-year2014-07-01683
Total number of active participants reported on line 7a of the Form 55002014-07-01729
Total of all active and inactive participants2014-07-01729
2013: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2013 401k membership
Total participants, beginning-of-year2013-07-01811
Total number of active participants reported on line 7a of the Form 55002013-07-01683
Total of all active and inactive participants2013-07-01683
2012: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2012 401k membership
Total participants, beginning-of-year2012-07-01717
Total number of active participants reported on line 7a of the Form 55002012-07-01811
Total of all active and inactive participants2012-07-01811
2011: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2011 401k membership
Total participants, beginning-of-year2011-07-01691
Total number of active participants reported on line 7a of the Form 55002011-07-01717
Total of all active and inactive participants2011-07-01717
2009: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2009 401k membership
Total participants, beginning-of-year2009-07-01610
Total number of active participants reported on line 7a of the Form 55002009-07-01612
Total of all active and inactive participants2009-07-01612

Form 5500 Responses for WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS

2022: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: WHEELER CLINIC INC. EMPLOYEE GROUP INSURANCE PLANS 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7579212
Policy instance 3
Insurance contract or identification numberE7579212
Number of Individuals Covered19
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $2,757
Total amount of fees paid to insurance companyUSD $134
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,812
Amount paid for insurance broker fees92
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberCM10000070
Policy instance 2
Insurance contract or identification numberCM10000070
Number of Individuals Covered702
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $-890
Total amount of fees paid to insurance companyUSD $2,528
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $116,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-890
Amount paid for insurance broker fees2528
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number1279
Policy instance 1
Insurance contract or identification number1279
Number of Individuals Covered710
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $3,291
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,291
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7579212
Policy instance 3
Insurance contract or identification numberE7579212
Number of Individuals Covered21
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $3,166
Total amount of fees paid to insurance companyUSD $664
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,320
Amount paid for insurance broker fees383
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberCM10000070
Policy instance 2
Insurance contract or identification numberCM10000070
Number of Individuals Covered709
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $2,165
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $98,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,165
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number1279
Policy instance 1
Insurance contract or identification number1279
Number of Individuals Covered668
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $3,915
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,913
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number1279
Policy instance 1
Insurance contract or identification number1279
Number of Individuals Covered725
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $3,266
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,293
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberCM10000070
Policy instance 2
Insurance contract or identification numberCM10000070
Number of Individuals Covered781
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $8,562
Total amount of fees paid to insurance companyUSD $5,498
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $102,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,041
Amount paid for insurance broker fees5498
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7579212
Policy instance 3
Insurance contract or identification numberE7579212
Number of Individuals Covered22
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $5,947
Total amount of fees paid to insurance companyUSD $2,008
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,701
Amount paid for insurance broker fees1639
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539630
Policy instance 2
Insurance contract or identification number00539630
Number of Individuals Covered777
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,658
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $192,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8658
Insurance broker organization code?3
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered858
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $511,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539630
Policy instance 2
Insurance contract or identification number00539630
Number of Individuals Covered749
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,137
Total amount of fees paid to insurance companyUSD $7,338
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $195,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,137
Amount paid for insurance broker fees7338
Insurance broker organization code?3
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered836
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $954
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $442,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $954
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539630
Policy instance 2
Insurance contract or identification number00539630
Number of Individuals Covered758
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $14,742
Total amount of fees paid to insurance companyUSD $7,704
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $461,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,742
Amount paid for insurance broker fees7704
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered845
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $4,025
Total amount of fees paid to insurance companyUSD $1,197
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,025
Amount paid for insurance broker fees1197
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION COMMUNICATION AND TRAINING
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered561
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $3,531
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $481,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,531
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered739
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $161,407
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 number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered484
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $3,209
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $418,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,209
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC.
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered729
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $9,086
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $129,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,086
Insurance broker organization code?3
Insurance broker nameOVATION BENEFITS GROUP LLC
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered499
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $9,387
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $375,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,214
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameOVATION BENEFITS GROUP LLC
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered683
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $9,771
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $120,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,771
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameOVATION BENEFITS GROUP LLC
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered460
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $2,600
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $391,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,600
Insurance broker organization code?3
Insurance broker nameOVATION BENEFITS GROUP LLC
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered811
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $8,769
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $134,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,769
Insurance broker organization code?3
Insurance broker nameOVATION BENEFITS GROUP LLC
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered479
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $1,932
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $311,248
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 number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered717
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $7,621
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $83,228
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 number001279
Policy instance 1
Insurance contract or identification number001279
Number of Individuals Covered481
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,384
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 number001279E
Policy instance 2
Insurance contract or identification number001279E
Number of Individuals Covered583
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $9,126
Total amount of fees paid to insurance companyUSD $1,724
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $111,385
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 number001279
Policy instance 3
Insurance contract or identification number001279
Number of Individuals Covered481
Insurance policy start date2011-04-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,338
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 number001279E
Policy instance 4
Insurance contract or identification number001279E
Number of Individuals Covered691
Insurance policy start date2011-06-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $-346
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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