AN.DEL.USA, INC. & SUBSIDIARIES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AN. DEL. U.S.A. INC. & SUBSIDIARIES
401k plan membership statisitcs for AN. DEL. U.S.A. INC. & SUBSIDIARIES
| Measure | Date | Value |
|---|
| 2022: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-06-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 197 |
| Total of all active and inactive participants | 2022-06-01 | 197 |
| 2021: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-06-01 | 215 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 200 |
| Total of all active and inactive participants | 2021-06-01 | 200 |
| 2020: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 234 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 215 |
| Total of all active and inactive participants | 2020-06-01 | 215 |
| 2019: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 236 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 234 |
| Total of all active and inactive participants | 2019-06-01 | 234 |
| 2018: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 216 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 236 |
| Total of all active and inactive participants | 2018-06-01 | 236 |
| 2017: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 216 |
| Total of all active and inactive participants | 2017-06-01 | 216 |
| 2016: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 271 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 221 |
| Total of all active and inactive participants | 2016-06-01 | 221 |
| 2015: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 271 |
| Total of all active and inactive participants | 2015-06-01 | 271 |
| 2014: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 204 |
| Total of all active and inactive participants | 2014-06-01 | 204 |
| 2013: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 205 |
| Total of all active and inactive participants | 2013-06-01 | 205 |
| 2012: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 186 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 202 |
| Total of all active and inactive participants | 2012-06-01 | 202 |
| 2011: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 186 |
| Total of all active and inactive participants | 2011-06-01 | 186 |
| 2009: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 178 |
| Total of all active and inactive participants | 2009-06-01 | 178 |
| 2008: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-06-01 | 188 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-06-01 | 197 |
| Total of all active and inactive participants | 2008-06-01 | 197 |
| 2007: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-06-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-06-01 | 188 |
| Total of all active and inactive participants | 2007-06-01 | 188 |
| 2006: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-06-01 | 257 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-06-01 | 212 |
| Total of all active and inactive participants | 2006-06-01 | 212 |
| 2005: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-06-01 | 242 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-06-01 | 257 |
| Total of all active and inactive participants | 2005-06-01 | 257 |
| 2004: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-06-01 | 187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-06-01 | 242 |
| Total of all active and inactive participants | 2004-06-01 | 242 |
| 2003: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-06-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-06-01 | 187 |
| Total of all active and inactive participants | 2003-06-01 | 187 |
| 2002: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-06-01 | 268 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-06-01 | 195 |
| Total of all active and inactive participants | 2002-06-01 | 195 |
| 2001: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-06-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-06-01 | 268 |
| Total of all active and inactive participants | 2001-06-01 | 268 |
| 2022: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | This submission is the final filing | No |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2008 form 5500 responses |
|---|
| 2008-06-01 | Type of plan entity | Single employer plan |
| 2008-06-01 | This submission is the final filing | No |
| 2008-06-01 | Plan funding arrangement – Insurance | Yes |
| 2008-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2007 form 5500 responses |
|---|
| 2007-06-01 | Type of plan entity | Single employer plan |
| 2007-06-01 | This submission is the final filing | No |
| 2007-06-01 | Plan funding arrangement – Insurance | Yes |
| 2007-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2006 form 5500 responses |
|---|
| 2006-06-01 | Type of plan entity | Single employer plan |
| 2006-06-01 | This submission is the final filing | No |
| 2006-06-01 | Plan funding arrangement – Insurance | Yes |
| 2006-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2005 form 5500 responses |
|---|
| 2005-06-01 | Type of plan entity | Single employer plan |
| 2005-06-01 | This submission is the final filing | No |
| 2005-06-01 | Plan funding arrangement – Insurance | Yes |
| 2005-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2004 form 5500 responses |
|---|
| 2004-06-01 | Type of plan entity | Single employer plan |
| 2004-06-01 | This submission is the final filing | No |
| 2004-06-01 | Plan funding arrangement – Insurance | Yes |
| 2004-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2003 form 5500 responses |
|---|
| 2003-06-01 | Type of plan entity | Single employer plan |
| 2003-06-01 | This submission is the final filing | No |
| 2003-06-01 | Plan funding arrangement – Insurance | Yes |
| 2003-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2002 form 5500 responses |
|---|
| 2002-06-01 | Type of plan entity | Single employer plan |
| 2002-06-01 | This submission is the final filing | No |
| 2002-06-01 | Plan funding arrangement – Insurance | Yes |
| 2002-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: AN. DEL. U.S.A. INC. & SUBSIDIARIES 2001 form 5500 responses |
|---|
| 2001-06-01 | Type of plan entity | Single employer plan |
| 2001-06-01 | First time form 5500 has been submitted | Yes |
| 2001-06-01 | This submission is the final filing | No |
| 2001-06-01 | Plan funding arrangement – Insurance | Yes |
| 2001-06-01 | Plan benefit arrangement – Insurance | Yes |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 094363 |
| Policy instance | 3 |
| Insurance contract or identification number | 094363 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,977 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 803692G |
| Policy instance | 2 |
| Insurance contract or identification number | 803692G | | Number of Individuals Covered | 151 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $2,757 | | Total amount of fees paid to insurance company | USD $663 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $68,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,847 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ALLOCATION OF CONTINGENT COMPENSATION PAYABLE TOPRODUCER. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914825 |
| Policy instance | 1 |
| Insurance contract or identification number | 914825 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $64,086 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,421,887 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,916 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914825 |
| Policy instance | 1 |
| Insurance contract or identification number | 914825 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $59,884 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,478,120 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,973 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 803692G |
| Policy instance | 2 |
| Insurance contract or identification number | 803692G | | Number of Individuals Covered | 148 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $353 | | Total amount of fees paid to insurance company | USD $733 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $69,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 733 | | Additional information about fees paid to insurance broker | ALLOCATION OF CONTINGENT COMPENSATION PAYABLE TO PRODUCER. | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $353 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914825 |
| Policy instance | 1 |
| Insurance contract or identification number | 914825 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $60,986 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,507,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,708 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 803692G |
| Policy instance | 2 |
| Insurance contract or identification number | 803692G | | Number of Individuals Covered | 152 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $4,312 | | Total amount of fees paid to insurance company | USD $320 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $79,414 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,809 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | ALLOCATION OF CONTINGENT COMPENSATION PAYABLE TO THE NAMED PRODUCER. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914825 |
| Policy instance | 1 |
| Insurance contract or identification number | 914825 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $66,576 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,654,763 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,439 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 803692G |
| Policy instance | 2 |
| Insurance contract or identification number | 803692G | | Number of Individuals Covered | 191 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $6,894 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $86,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,447 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 914825 |
| Policy instance | 2 |
| Insurance contract or identification number | 914825 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $61,020 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,514,845 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,731 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0686232 |
| Policy instance | 1 |
| Insurance contract or identification number | 0686232 | | Number of Individuals Covered | 186 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $3,186 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $80,105 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,127 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $62,333 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,500,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,288 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0686232 |
| Policy instance | 1 |
| Insurance contract or identification number | 0686232 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $3,106 | | Total amount of fees paid to insurance company | USD $1,535 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $77,601 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,071 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1535 | | Additional information about fees paid to insurance broker | 2017-2018 PPP INCENTIVE GI | | Insurance broker name | VINCENZO VENTURI |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0686232 |
| Policy instance | 1 |
| Insurance contract or identification number | 0686232 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $2,803 | | Total amount of fees paid to insurance company | USD $776 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $70,552 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,067 | | Amount paid for insurance broker fees | 776 | | Additional information about fees paid to insurance broker | 2014/2015 PPP ENGAGEMENT CREDIT | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $62,757 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,517,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,434 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | VINCENZO VENTURI |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0686232 |
| Policy instance | 1 |
| Insurance contract or identification number | 0686232 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $2,160 | | 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 | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $59,515 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $797 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $61,429 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $1,267,779 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,003 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | VINCENZO VENTURI |
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $45,899 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $1,098,208 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,295 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SERVICES OF MN INC |
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| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 10138970 |
| Policy instance | 3 |
| Insurance contract or identification number | 10138970 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,699 | | Total amount of fees paid to insurance company | USD $552 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | WEEKLY INCOME | | Welfare Benefit Premiums Paid to Carrier | USD $39,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,371 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 10138969 |
| Policy instance | 4 |
| Insurance contract or identification number | 10138969 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,547 | | Total amount of fees paid to insurance company | USD $261 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $17,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,398 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05557931 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05557931 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $7,837 | | Total amount of fees paid to insurance company | USD $2,166 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $116,374 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,535 | | Amount paid for insurance broker fees | 990 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | RUSNAK HEATHER |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05557931 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05557931 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $7,456 | | Total amount of fees paid to insurance company | USD $2,126 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $112,356 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,017 | | Amount paid for insurance broker fees | 2128 | | Additional information about fees paid to insurance broker | NON MONETARY COMPENSATION & SUPPLEMENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SERVICES OF NY INC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 10138970 |
| Policy instance | 3 |
| Insurance contract or identification number | 10138970 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,832 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $39,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,935 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $41,212 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $973,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,781 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INS SERVICES OF NY INC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 10138969 |
| Policy instance | 3 |
| Insurance contract or identification number | 10138969 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $2,291 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $15,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05557931 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05557931 | | Number of Individuals Covered | 186 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $7,001 | | Total amount of fees paid to insurance company | USD $457 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $100,142 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $31,256 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $837,105 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 376055 |
| Policy instance | 3 |
| Insurance contract or identification number | 376055 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $4,992 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $64,964 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 533763 |
| Policy instance | 2 |
| Insurance contract or identification number | 533763 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $43,544 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $782,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05557931 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05557931 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $7,274 | | 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 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $99,188 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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