AUGERMAN INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AUGERMAN,INC EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2019: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 71 |
| Total of all active and inactive participants | 2019-03-01 | 71 |
| Number of retired or separated participants receiving benefits | 2019-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 0 |
| Number of employers contributing to the scheme | 2019-03-01 | 0 |
| 2018: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 91 |
| Total of all active and inactive participants | 2018-03-01 | 91 |
| 2017: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 86 |
| Total of all active and inactive participants | 2017-03-01 | 86 |
| 2016: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 95 |
| Total of all active and inactive participants | 2016-03-01 | 95 |
| 2015: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 172 |
| Total of all active and inactive participants | 2015-03-01 | 172 |
| 2014: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 101 |
| Total of all active and inactive participants | 2014-03-01 | 101 |
| 2013: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 106 |
| Total of all active and inactive participants | 2013-03-01 | 106 |
| 2012: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 85 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 106 |
| Total of all active and inactive participants | 2012-03-01 | 106 |
| 2011: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 85 |
| Total of all active and inactive participants | 2011-03-01 | 85 |
| 2019: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Submission has been amended | Yes |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: AUGERMAN,INC EMPLOYEE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | First time form 5500 has been submitted | Yes |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan funding arrangement – Trust | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement - Trust | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 165087 |
| Policy instance | 3 |
| Insurance contract or identification number | 165087 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $28,135 | | Total amount of fees paid to insurance company | USD $5,190 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $498,065 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,135 | | Amount paid for insurance broker fees | 5190 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AS5E |
| Policy instance | 2 |
| Insurance contract or identification number | G000AS5E | | Number of Individuals Covered | 71 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $7,412 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,411 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,412 | | Insurance broker organization code? | 3 |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 71 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $625 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $625 | | Insurance broker organization code? | 3 |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 91 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $703 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,033 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $703 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AS5E |
| Policy instance | 2 |
| Insurance contract or identification number | G000AS5E | | Number of Individuals Covered | 91 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $9,554 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,470 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,554 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 165087 |
| Policy instance | 3 |
| Insurance contract or identification number | 165087 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $29,554 | | Total amount of fees paid to insurance company | USD $6,069 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $503,171 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,554 | | Amount paid for insurance broker fees | 6069 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05345766 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05345766 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $42,413 | | 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 | TS05345766 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05345766 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $2,311 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,311 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 165087 |
| Policy instance | 3 |
| Insurance contract or identification number | 165087 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $28,724 | | Total amount of fees paid to insurance company | USD $7,160 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $575,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,724 | | Amount paid for insurance broker fees | 7160 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AS5E |
| Policy instance | 2 |
| Insurance contract or identification number | G000AS5E | | Number of Individuals Covered | 94 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $8,842 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,842 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 86 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $751 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,211 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $751 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05345766 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05345766 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $2,572 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,572 | | Insurance broker organization code? | 5 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 172 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $29,556 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $616,942 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,556 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AS5E |
| Policy instance | 2 |
| Insurance contract or identification number | G000AS5E | | Number of Individuals Covered | 107 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $2,680 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,870 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,680 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 172 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $749 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $749 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 87 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,322 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $832 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 87 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $33,548 | | Total amount of fees paid to insurance company | USD $43,947 | | 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 $223,653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,183 | | Amount paid for insurance broker fees | 36467 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AS5E |
| Policy instance | 3 |
| Insurance contract or identification number | G000AS5E | | Number of Individuals Covered | 101 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $2,681 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $17,874 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,681 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $2,602 | | 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 | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $17,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,602 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $39,603 | | Total amount of fees paid to insurance company | USD $33,281 | | 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 $265,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,603 | | Amount paid for insurance broker fees | 25649 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $905 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $905 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $2,817 | | 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 | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $16,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,817 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $922 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,222 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $922 | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 106 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $35,937 | | Total amount of fees paid to insurance company | USD $33,564 | | 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 $239,580 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,937 | | Amount paid for insurance broker fees | 7554 | | Additional information about fees paid to insurance broker | BROKER FES | | Insurance broker organization code? | 3 | | Insurance broker name | EBS EMPLOYEE BENEFIT SERVICES, INC. |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | NOT AVAIL |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAIL | | Number of Individuals Covered | 85 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $31,876 | | Total amount of fees paid to insurance company | USD $31,168 | | 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 $212,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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