INTERIM HEALTHCARE OF HARTFORD, has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN
401k plan membership statisitcs for INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN
Measure | Date | Value |
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2017: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 107 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 96 |
Total of all active and inactive participants | 2017-05-01 | 96 |
2016: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 107 |
Total of all active and inactive participants | 2016-05-01 | 107 |
2015: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 101 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 105 |
Total of all active and inactive participants | 2015-05-01 | 105 |
2014: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 124 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 101 |
Total of all active and inactive participants | 2014-05-01 | 101 |
2013: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 149 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 124 |
Total of all active and inactive participants | 2013-05-01 | 124 |
2012: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 114 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 149 |
Total of all active and inactive participants | 2012-05-01 | 149 |
2011: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 190 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 114 |
Total of all active and inactive participants | 2011-05-01 | 114 |
2010: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-05-01 | 201 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 190 |
Total of all active and inactive participants | 2010-05-01 | 190 |
2009: INTERIM HEALTHCARE OF HARTFORD EMPLOYEE WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 198 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 201 |
Total of all active and inactive participants | 2009-05-01 | 201 |
HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0146050000 |
Policy instance | 9 |
Insurance contract or identification number | 0146050000 | Number of Individuals Covered | 2 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $331 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $331 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001 |
Policy instance | 1 |
Insurance contract or identification number | 848001 | Number of Individuals Covered | 111 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $3,368 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,368 | Insurance broker organization code? | 3 | Insurance broker name | |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SGM603226 |
Policy instance | 2 |
Insurance contract or identification number | SGM603226 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $1,248 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,248 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT600687 |
Policy instance | 3 |
Insurance contract or identification number | VDT600687 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $2,517 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,517 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
Policy contract number | 800648 |
Policy instance | 4 |
Insurance contract or identification number | 800648 | Number of Individuals Covered | 42 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $591 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $591 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SOK602049 |
Policy instance | 5 |
Insurance contract or identification number | SOK602049 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-05-01 | Total amount of commissions paid to insurance broker | USD $324 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $324 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0146030000 |
Policy instance | 6 |
Insurance contract or identification number | 0146030000 | Number of Individuals Covered | 9 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,945 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,945 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0146040000 |
Policy instance | 7 |
Insurance contract or identification number | 0146040000 | Number of Individuals Covered | 85 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $15,497 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,497 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0146040001 |
Policy instance | 8 |
Insurance contract or identification number | 0146040001 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $51 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
Policy contract number | 800648 |
Policy instance | 5 |
Insurance contract or identification number | 800648 | Number of Individuals Covered | 42 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $373 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $373 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT600687 |
Policy instance | 4 |
Insurance contract or identification number | VDT600687 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $2,523 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,523 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SGM603226 |
Policy instance | 3 |
Insurance contract or identification number | SGM603226 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,147 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,147 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001 |
Policy instance | 2 |
Insurance contract or identification number | 848001 | Number of Individuals Covered | 133 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $2,822 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,822 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA HEALTH, INC (National Association of Insurance Commissioners NAIC id number: 95935 ) |
Policy contract number | 0848001-HNO |
Policy instance | 1 |
Insurance contract or identification number | 0848001-HNO | Number of Individuals Covered | 105 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $36,679 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,679 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT600687 |
Policy instance | 4 |
Insurance contract or identification number | VDT600687 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,800 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,800 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SOK602049 |
Policy instance | 5 |
Insurance contract or identification number | SOK602049 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $333 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $333 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
Policy contract number | 800648 |
Policy instance | 6 |
Insurance contract or identification number | 800648 | Number of Individuals Covered | 34 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $340 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $340 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SGM603226 |
Policy instance | 3 |
Insurance contract or identification number | SGM603226 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,162 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,162 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001 |
Policy instance | 2 |
Insurance contract or identification number | 848001 | Number of Individuals Covered | 136 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $3,067 | 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 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,067 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA HEALTH, INC (National Association of Insurance Commissioners NAIC id number: 95935 ) |
Policy contract number | 0848001-HNO |
Policy instance | 1 |
Insurance contract or identification number | 0848001-HNO | Number of Individuals Covered | 101 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $30,059 | Total amount of fees paid to insurance company | USD $781 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,059 | Amount paid for insurance broker fees | 781 | Additional information about fees paid to insurance broker | MM BONUS | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SGM603226 |
Policy instance | 3 |
Insurance contract or identification number | SGM603226 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,490 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,490 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT600687 |
Policy instance | 4 |
Insurance contract or identification number | VDT600687 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,352 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,352 | Amount paid for insurance broker fees | 0 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0848001-HNO |
Policy instance | 1 |
Insurance contract or identification number | 0848001-HNO | Number of Individuals Covered | 124 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $28,644 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,644 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001 |
Policy instance | 2 |
Insurance contract or identification number | 848001 | Number of Individuals Covered | 158 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $3,691 | Total amount of fees paid to insurance company | USD $39 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,691 | Amount paid for insurance broker fees | 39 | Additional information about fees paid to insurance broker | PM CROSS- SALE | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SOK602049 |
Policy instance | 5 |
Insurance contract or identification number | SOK602049 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $425 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $425 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
Policy contract number | 800648 |
Policy instance | 6 |
Insurance contract or identification number | 800648 | Number of Individuals Covered | 29 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $312 | 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 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $312 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SGM603226 |
Policy instance | 3 |
Insurance contract or identification number | SGM603226 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,491 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,491 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT600687 |
Policy instance | 4 |
Insurance contract or identification number | VDT600687 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,352 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,352 | Amount paid for insurance broker fees | 0 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | SOK602049 |
Policy instance | 5 |
Insurance contract or identification number | SOK602049 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $425 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $425 | Amount paid for insurance broker fees | 0 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001-HNO |
Policy instance | 2 |
Insurance contract or identification number | 848001-HNO | Number of Individuals Covered | 181 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $3,546 | Total amount of fees paid to insurance company | USD $1,041 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,546 | Amount paid for insurance broker fees | 1041 | Additional information about fees paid to insurance broker | PM CROSS AND SUPPLEMENTAL | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 848001-HNO |
Policy instance | 1 |
Insurance contract or identification number | 848001-HNO | Number of Individuals Covered | 149 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $32,747 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,747 | Insurance broker organization code? | 3 | Insurance broker name | SMITH BROTHERS INSURANCE INC |
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ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
Policy contract number | 266787 |
Policy instance | 3 |
Insurance contract or identification number | 266787 | Number of Individuals Covered | 114 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,408 | 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 | 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 | 266787 |
Policy instance | 1 |
Insurance contract or identification number | 266787 | Number of Individuals Covered | 114 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $7,300 | 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 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | 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 | 266787 |
Policy instance | 2 |
Insurance contract or identification number | 266787 | Number of Individuals Covered | 110 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $6,981 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUGO977B |
Policy instance | 2 |
Insurance contract or identification number | GLUGO977B | Number of Individuals Covered | 101 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $2,735 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05536821 |
Policy instance | 1 |
Insurance contract or identification number | TM05536821 | Number of Individuals Covered | 190 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $7,332 | 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 | Dental Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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