BUDNEY OVERHAUL & REPAIR, LTD. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BUDNEY OVERHAUL & REPAIR DENTAL PLAN
| Measure | Date | Value |
|---|
| 2020: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2019: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 129 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 129 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 141 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 141 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 141 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 141 |
| Number of employers contributing to the scheme | 2017-01-01 | 0 |
| 2016: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 141 |
| Number of retired or separated participants receiving benefits | 2016-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
| Total of all active and inactive participants | 2016-12-01 | 141 |
| Number of employers contributing to the scheme | 2016-12-01 | 0 |
| 2015: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 138 |
| Number of retired or separated participants receiving benefits | 2015-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-12-01 | 0 |
| Total of all active and inactive participants | 2015-12-01 | 138 |
| Number of employers contributing to the scheme | 2015-12-01 | 0 |
| 2014: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2014-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-12-01 | 0 |
| Total of all active and inactive participants | 2014-12-01 | 126 |
| Number of employers contributing to the scheme | 2014-12-01 | 0 |
| 2013: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-01 | 151 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2013-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-12-01 | 0 |
| Total of all active and inactive participants | 2013-12-01 | 126 |
| Number of employers contributing to the scheme | 2013-12-01 | 0 |
| 2012: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-01 | 151 |
| Number of retired or separated participants receiving benefits | 2012-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-12-01 | 0 |
| Total of all active and inactive participants | 2012-12-01 | 151 |
| Number of employers contributing to the scheme | 2012-12-01 | 0 |
| 2011: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2011-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-12-01 | 0 |
| Total of all active and inactive participants | 2011-12-01 | 126 |
| Number of employers contributing to the scheme | 2011-12-01 | 0 |
| 2010: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2010-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-12-01 | 0 |
| Total of all active and inactive participants | 2010-12-01 | 126 |
| Number of employers contributing to the scheme | 2010-12-01 | 0 |
| 2009: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2009-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-12-01 | 0 |
| Total of all active and inactive participants | 2009-12-01 | 126 |
| Number of employers contributing to the scheme | 2009-12-01 | 0 |
| 2008: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-12-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-12-01 | 126 |
| Number of retired or separated participants receiving benefits | 2008-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-12-01 | 0 |
| Total of all active and inactive participants | 2008-12-01 | 126 |
| Number of employers contributing to the scheme | 2008-12-01 | 0 |
| 2007: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-12-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-12-01 | 142 |
| Number of retired or separated participants receiving benefits | 2007-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-12-01 | 0 |
| Total of all active and inactive participants | 2007-12-01 | 142 |
| Number of employers contributing to the scheme | 2007-12-01 | 0 |
| 2006: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-12-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-12-01 | 100 |
| Number of retired or separated participants receiving benefits | 2006-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-12-01 | 0 |
| Total of all active and inactive participants | 2006-12-01 | 100 |
| Number of employers contributing to the scheme | 2006-12-01 | 0 |
| 2020: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2016 form 5500 responses |
|---|
| 2016-12-01 | Type of plan entity | Single employer plan |
| 2016-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2015 form 5500 responses |
|---|
| 2015-12-01 | Type of plan entity | Single employer plan |
| 2015-12-01 | Plan funding arrangement – Insurance | Yes |
| 2015-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2014 form 5500 responses |
|---|
| 2014-12-01 | Type of plan entity | Single employer plan |
| 2014-12-01 | Plan funding arrangement – Insurance | Yes |
| 2014-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2013 form 5500 responses |
|---|
| 2013-12-01 | Type of plan entity | Single employer plan |
| 2013-12-01 | Plan funding arrangement – Insurance | Yes |
| 2013-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2012 form 5500 responses |
|---|
| 2012-12-01 | Type of plan entity | Single employer plan |
| 2012-12-01 | Plan funding arrangement – Insurance | Yes |
| 2012-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2011 form 5500 responses |
|---|
| 2011-12-01 | Type of plan entity | Single employer plan |
| 2011-12-01 | Plan funding arrangement – Insurance | Yes |
| 2011-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2010 form 5500 responses |
|---|
| 2010-12-01 | Type of plan entity | Single employer plan |
| 2010-12-01 | Plan funding arrangement – Insurance | Yes |
| 2010-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2009 form 5500 responses |
|---|
| 2009-12-01 | Type of plan entity | Single employer plan |
| 2009-12-01 | Plan funding arrangement – Insurance | Yes |
| 2009-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2008 form 5500 responses |
|---|
| 2008-12-01 | Type of plan entity | Single employer plan |
| 2008-12-01 | Plan funding arrangement – Insurance | Yes |
| 2008-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2007 form 5500 responses |
|---|
| 2007-12-01 | Type of plan entity | Single employer plan |
| 2007-12-01 | Plan funding arrangement – Insurance | Yes |
| 2007-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: BUDNEY OVERHAUL & REPAIR DENTAL PLAN 2006 form 5500 responses |
|---|
| 2006-12-01 | Type of plan entity | Single employer plan |
| 2006-12-01 | First time form 5500 has been submitted | Yes |
| 2006-12-01 | Plan funding arrangement – Insurance | Yes |
| 2006-12-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916514 |
| Policy instance | 1 |
| Insurance contract or identification number | 0916514 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,664 | | Total amount of fees paid to insurance company | USD $6,809 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $145,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,664 | | Amount paid for insurance broker fees | 6809 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916514 |
| Policy instance | 1 |
| Insurance contract or identification number | 0916514 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,451 | | Total amount of fees paid to insurance company | USD $4,855 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,713 | | 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 | 518253 |
| Policy instance | 1 |
| Insurance contract or identification number | 518253 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) |
| Policy contract number | 518253 |
| Policy instance | 1 |
| Insurance contract or identification number | 518253 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2016-12-01 | | Insurance policy end date | 2016-12-31 | | Total amount of commissions paid to insurance broker | USD $559 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,786 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $559 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2015-12-01 | | Insurance policy end date | 2016-11-30 | | Total amount of commissions paid to insurance broker | USD $6,084 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $160,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,805 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 301 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $6,070 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $157,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,070 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $5,477 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $133,397 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,477 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 354 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $9,104 | | Total amount of fees paid to insurance company | USD $251 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $147,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,104 | | Amount paid for insurance broker fees | 251 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1021893 |
| Policy instance | 1 |
| Insurance contract or identification number | 1021893 | | Number of Individuals Covered | 296 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $9,110 | | Total amount of fees paid to insurance company | USD $3,187 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $154,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,110 | | Amount paid for insurance broker fees | 3187 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 211523 |
| Policy instance | 1 |
| Insurance contract or identification number | 211523 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Total amount of commissions paid to insurance broker | USD $3,305 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $96,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,305 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 647564 |
| Policy instance | 1 |
| Insurance contract or identification number | 647564 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2009-12-01 | | Insurance policy end date | 2010-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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? | Yes |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1001457 |
| Policy instance | 1 |
| Insurance contract or identification number | 1001457 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2008-12-01 | | Insurance policy end date | 2009-11-30 | | Total amount of commissions paid to insurance broker | USD $5,084 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $97,216 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,084 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1001457 |
| Policy instance | 1 |
| Insurance contract or identification number | 1001457 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2007-12-01 | | Insurance policy end date | 2008-11-30 | | Total amount of commissions paid to insurance broker | USD $5,600 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,353 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,600 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 3328727 |
| Policy instance | 1 |
| Insurance contract or identification number | 3328727 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2006-12-01 | | Insurance policy end date | 2007-11-30 | | Total amount of commissions paid to insurance broker | USD $0 | | 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? | Yes |
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