NATIONAL RESTAURANTS MANAGEMEN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2012: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 79 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 79 |
| 2010: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 95 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 95 |
| 2009: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 109 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 109 |
| 2008: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-01-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 159 |
| Number of retired or separated participants receiving benefits | 2008-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-01-01 | 0 |
| Total of all active and inactive participants | 2008-01-01 | 159 |
| 2007: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 124 |
| Number of retired or separated participants receiving benefits | 2007-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-01-01 | 0 |
| Total of all active and inactive participants | 2007-01-01 | 124 |
| 2006: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-01-01 | 120 |
| Number of retired or separated participants receiving benefits | 2006-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-01-01 | 0 |
| Total of all active and inactive participants | 2006-01-01 | 120 |
| 2005: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-01-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-01-01 | 120 |
| Number of retired or separated participants receiving benefits | 2005-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-01-01 | 0 |
| Total of all active and inactive participants | 2005-01-01 | 120 |
| 2004: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-01-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-01-01 | 219 |
| Number of retired or separated participants receiving benefits | 2004-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-01-01 | 0 |
| Total of all active and inactive participants | 2004-01-01 | 219 |
| 2003: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-01-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-01-01 | 219 |
| Number of retired or separated participants receiving benefits | 2003-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-01-01 | 0 |
| Total of all active and inactive participants | 2003-01-01 | 219 |
| 2002: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-01-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-01-01 | 219 |
| Number of retired or separated participants receiving benefits | 2002-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2002-01-01 | 0 |
| Total of all active and inactive participants | 2002-01-01 | 219 |
| 2001: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-01-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-01-01 | 214 |
| Number of retired or separated participants receiving benefits | 2001-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2001-01-01 | 0 |
| Total of all active and inactive participants | 2001-01-01 | 214 |
| 2000: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-01-01 | 226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-01-01 | 204 |
| Number of retired or separated participants receiving benefits | 2000-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2000-01-01 | 0 |
| Total of all active and inactive participants | 2000-01-01 | 204 |
| 1999: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1999 401k membership |
|---|
| Total participants, beginning-of-year | 1999-01-01 | 235 |
| Total number of active participants reported on line 7a of the Form 5500 | 1999-01-01 | 226 |
| Number of retired or separated participants receiving benefits | 1999-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1999-01-01 | 0 |
| Total of all active and inactive participants | 1999-01-01 | 226 |
| 1998: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1998 401k membership |
|---|
| Total participants, beginning-of-year | 1998-01-01 | 252 |
| Total number of active participants reported on line 7a of the Form 5500 | 1998-01-01 | 235 |
| Number of retired or separated participants receiving benefits | 1998-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1998-01-01 | 0 |
| Total of all active and inactive participants | 1998-01-01 | 235 |
| 1997: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1997 401k membership |
|---|
| Total participants, beginning-of-year | 1997-01-01 | 250 |
| Total number of active participants reported on line 7a of the Form 5500 | 1997-01-01 | 252 |
| Number of retired or separated participants receiving benefits | 1997-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1997-01-01 | 0 |
| Total of all active and inactive participants | 1997-01-01 | 252 |
| 1996: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1996 401k membership |
|---|
| Total participants, beginning-of-year | 1996-01-01 | 250 |
| Total number of active participants reported on line 7a of the Form 5500 | 1996-01-01 | 250 |
| Number of retired or separated participants receiving benefits | 1996-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1996-01-01 | 0 |
| Total of all active and inactive participants | 1996-01-01 | 250 |
| 2012: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Multi-employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Multi-employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Multi-employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2008 form 5500 responses |
|---|
| 2008-01-01 | Type of plan entity | Multi-employer plan |
| 2008-01-01 | Submission has been amended | No |
| 2008-01-01 | This submission is the final filing | No |
| 2008-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-01-01 | Plan is a collectively bargained plan | No |
| 2008-01-01 | Plan funding arrangement – Insurance | Yes |
| 2008-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2007 form 5500 responses |
|---|
| 2007-01-01 | Type of plan entity | Multi-employer plan |
| 2007-01-01 | Submission has been amended | No |
| 2007-01-01 | This submission is the final filing | No |
| 2007-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-01-01 | Plan is a collectively bargained plan | No |
| 2007-01-01 | Plan funding arrangement – Insurance | Yes |
| 2007-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2006 form 5500 responses |
|---|
| 2006-01-01 | Type of plan entity | Multi-employer plan |
| 2006-01-01 | Submission has been amended | No |
| 2006-01-01 | This submission is the final filing | No |
| 2006-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-01-01 | Plan is a collectively bargained plan | No |
| 2006-01-01 | Plan funding arrangement – Insurance | Yes |
| 2006-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2005 form 5500 responses |
|---|
| 2005-01-01 | Type of plan entity | Multi-employer plan |
| 2005-01-01 | Submission has been amended | No |
| 2005-01-01 | This submission is the final filing | No |
| 2005-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-01-01 | Plan is a collectively bargained plan | No |
| 2005-01-01 | Plan funding arrangement – Insurance | Yes |
| 2005-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2004 form 5500 responses |
|---|
| 2004-01-01 | Type of plan entity | Multi-employer plan |
| 2004-01-01 | Submission has been amended | No |
| 2004-01-01 | This submission is the final filing | No |
| 2004-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-01-01 | Plan is a collectively bargained plan | No |
| 2004-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2004-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2003: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2003 form 5500 responses |
|---|
| 2003-01-01 | Type of plan entity | Multi-employer plan |
| 2003-01-01 | Submission has been amended | No |
| 2003-01-01 | This submission is the final filing | No |
| 2003-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-01-01 | Plan is a collectively bargained plan | No |
| 2003-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2003-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2002: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2002 form 5500 responses |
|---|
| 2002-01-01 | Type of plan entity | Multi-employer plan |
| 2002-01-01 | Submission has been amended | No |
| 2002-01-01 | This submission is the final filing | No |
| 2002-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-01-01 | Plan is a collectively bargained plan | No |
| 2002-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2002-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2001: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2001 form 5500 responses |
|---|
| 2001-01-01 | Type of plan entity | Multi-employer plan |
| 2001-01-01 | Submission has been amended | No |
| 2001-01-01 | This submission is the final filing | No |
| 2001-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-01-01 | Plan is a collectively bargained plan | No |
| 2001-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2001-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2000: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 2000 form 5500 responses |
|---|
| 2000-01-01 | Type of plan entity | Multi-employer plan |
| 2000-01-01 | Submission has been amended | No |
| 2000-01-01 | This submission is the final filing | No |
| 2000-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2000-01-01 | Plan is a collectively bargained plan | No |
| 2000-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2000-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 1999: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1999 form 5500 responses |
|---|
| 1999-01-01 | Type of plan entity | Multi-employer plan |
| 1999-01-01 | Submission has been amended | No |
| 1999-01-01 | This submission is the final filing | No |
| 1999-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1999-01-01 | Plan is a collectively bargained plan | No |
| 1999-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1999-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 1998: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1998 form 5500 responses |
|---|
| 1998-01-01 | Type of plan entity | Multi-employer plan |
| 1998-01-01 | Submission has been amended | No |
| 1998-01-01 | This submission is the final filing | No |
| 1998-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1998-01-01 | Plan is a collectively bargained plan | No |
| 1998-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1998-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 1997: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1997 form 5500 responses |
|---|
| 1997-01-01 | Type of plan entity | Multi-employer plan |
| 1997-01-01 | Submission has been amended | No |
| 1997-01-01 | This submission is the final filing | No |
| 1997-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1997-01-01 | Plan is a collectively bargained plan | No |
| 1997-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1997-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 1996: THE RIESE ORGANIZATION MEDICAL BENEFIT PLAN 1996 form 5500 responses |
|---|
| 1996-01-01 | Type of plan entity | Multi-employer plan |
| 1996-01-01 | First time form 5500 has been submitted | Yes |
| 1996-01-01 | Submission has been amended | No |
| 1996-01-01 | This submission is the final filing | No |
| 1996-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1996-01-01 | Plan is a collectively bargained plan | No |
| 1996-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 1996-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | RO4178 |
| Policy instance | 1 |
| Insurance contract or identification number | RO4178 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $34,743 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,170,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,743 | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | RO4178 |
| Policy instance | 1 |
| Insurance contract or identification number | RO4178 | | Number of Individuals Covered | 209 | | Insurance policy start date | 2009-06-01 | | Insurance policy end date | 2010-05-31 | | Total amount of commissions paid to insurance broker | USD $34,722 | | Total amount of fees paid to insurance company | USD $1,770 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,123,632 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3329173 |
| Policy instance | 2 |
| Insurance contract or identification number | 3329173 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2008-03-01 | | Insurance policy end date | 2008-03-31 | | Total amount of commissions paid to insurance broker | USD $3,440 | | Total amount of fees paid to insurance company | USD $1,720 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $85,679 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,440 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1720 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker name | CENTERSTONE INS. AND FINANCIAL SRVC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3329173 |
| Policy instance | 3 |
| Insurance contract or identification number | 3329173 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2008-04-01 | | Insurance policy end date | 2008-05-31 | | Total amount of commissions paid to insurance broker | USD $8,454 | | Total amount of fees paid to insurance company | USD $4,227 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $211,655 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $8,454 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4227 | | Additional information about fees paid to insurance broker | SERVICE FEES | | Insurance broker name | CENTERSTONE INS. AND FINANCIAL SRVC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3229173 |
| Policy instance | 1 |
| Insurance contract or identification number | 3229173 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2007-03-01 | | Insurance policy end date | 2008-02-28 | | Total amount of commissions paid to insurance broker | USD $58,002 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $966,707 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $38,668 | | Insurance broker organization code? | 3 | | Insurance broker name | WIB BROKERS, INC. |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | RO1083 |
| Policy instance | 3 |
| Insurance contract or identification number | RO1083 | | Number of Individuals Covered | 272 | | Insurance policy start date | 2007-02-01 | | Insurance policy end date | 2007-02-28 | | Total amount of commissions paid to insurance broker | USD $1,739 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $117,108 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,739 | | Insurance broker organization code? | 3 | | Insurance broker name | HARMONY INSURANCE BROKERAGE, INC. |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | RO1083 |
| Policy instance | 2 |
| Insurance contract or identification number | RO1083 | | Number of Individuals Covered | 272 | | Insurance policy start date | 2006-02-01 | | Insurance policy end date | 2007-01-31 | | Total amount of commissions paid to insurance broker | USD $37,398 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $951,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,384 | | Insurance broker organization code? | 3 | | Insurance broker name | HARMONY INSURANCE BROKERAGE, INC. |
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| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3329173 |
| Policy instance | 1 |
| Insurance contract or identification number | 3329173 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2007-02-01 | | Insurance policy end date | 2007-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 99235 |
| Policy instance | 2 |
| Insurance contract or identification number | 99235 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2005-02-01 | | Insurance policy end date | 2006-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 99235 |
| Policy instance | 1 |
| Insurance contract or identification number | 99235 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2006-02-01 | | Insurance policy end date | 2006-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 99235 |
| Policy instance | 1 |
| Insurance contract or identification number | 99235 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2004-02-01 | | Insurance policy end date | 2005-01-31 | | Total amount of commissions paid to insurance broker | USD $33,834 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $916,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $31,179 | | Insurance broker organization code? | 3 | | Insurance broker name | WARREN ROSEN |
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