SCHATZ UNDERGROUND, INC. has sponsored the creation of one or more 401k plans.
Additional information about SCHATZ UNDERGROUND, INC.
Submission information for form 5500 for 401k plan SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN
401k plan membership statisitcs for SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-03-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 83 |
| Number of retired or separated participants receiving benefits | 2022-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-03-01 | 0 |
| Total of all active and inactive participants | 2022-03-01 | 83 |
| 2021: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-03-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 93 |
| Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 0 |
| Total of all active and inactive participants | 2021-03-01 | 93 |
| 2020: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 105 |
| Number of retired or separated participants receiving benefits | 2020-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
| Total of all active and inactive participants | 2020-03-01 | 105 |
| 2019: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 109 |
| 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 |
| Total of all active and inactive participants | 2019-03-01 | 109 |
| 2018: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 106 |
| Total of all active and inactive participants | 2018-03-01 | 106 |
| 2017: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 112 |
| Total of all active and inactive participants | 2017-03-01 | 112 |
| 2016: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 109 |
| Total of all active and inactive participants | 2016-03-01 | 109 |
| 2015: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 109 |
| Total of all active and inactive participants | 2015-03-01 | 109 |
| 2014: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 344 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 334 |
| Total of all active and inactive participants | 2014-03-01 | 334 |
| 2013: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 344 |
| Total of all active and inactive participants | 2013-03-01 | 344 |
| 2012: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 292 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 313 |
| Total of all active and inactive participants | 2012-03-01 | 313 |
| 2011: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 292 |
| Total of all active and inactive participants | 2011-03-01 | 292 |
| 2010: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 262 |
| Total of all active and inactive participants | 2010-03-01 | 262 |
| 2009: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 262 |
| Total of all active and inactive participants | 2009-03-01 | 262 |
| 2022: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-03-01 | Type of plan entity | Single employer plan |
| 2022-03-01 | Plan funding arrangement – Insurance | Yes |
| 2022-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-03-01 | Type of plan entity | Single employer plan |
| 2021-03-01 | Plan funding arrangement – Insurance | Yes |
| 2021-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | Plan funding arrangement – Insurance | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2017: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2016: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2015: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2014: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2013: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2012: SCHATZ UNDERGROUND, INC. WELFARE 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 benefit arrangement – Insurance | Yes |
| 2011: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Submission has been amended | Yes |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SCHATZ UNDERGROUND, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0744245 |
| Policy instance | 2 |
| Insurance contract or identification number | 0744245 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $2,965 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,963 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,965 |
|
| GARDEN STATE LIFE/UNITYRE (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 83 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $21,000 | | Total amount of fees paid to insurance company | USD $33,761 | | Welfare Benefit Premiums Paid to Carrier | USD $141,209 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 22499 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $16,750 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0744245 |
| Policy instance | 2 |
| Insurance contract or identification number | 0744245 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $3,621 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,621 |
|
| GARDEN STATE LIFE/UNITYRE (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 93 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $23,930 | | Total amount of fees paid to insurance company | USD $36,358 | | Welfare Benefit Premiums Paid to Carrier | USD $157,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $115 | | Amount paid for insurance broker fees | 23647 | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 100 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $22,713 | | Welfare Benefit Premiums Paid to Carrier | USD $142,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,713 | | Insurance broker organization code? | 3 |
|
| FAIR AMERICAN INS AND REINS CO. (National Association of Insurance Commissioners NAIC id number: 35157 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 105 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $3,214 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,214 | | Insurance broker organization code? | 3 |
|
| FAIR AMERICAN INS AND REINS CO. (National Association of Insurance Commissioners NAIC id number: 35157 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 109 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $22,110 | | Welfare Benefit Premiums Paid to Carrier | USD $149,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,110 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 344 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $3,467 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,244 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,467 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 332 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $3,381 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,924 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,381 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| FAIR AMERICAN INS AND REINS CO. (National Association of Insurance Commissioners NAIC id number: 35157 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 106 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $21,222 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $154,771 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,222 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 112 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $21,189 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $145,847 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,189 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | JAMES TUNE |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $3,813 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,826 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,813 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417002412162 |
| Policy instance | 1 |
| Insurance contract or identification number | 417002412162 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-28 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $26,565 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $130,804 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 26565 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 334 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $3,159 | | Total amount of fees paid to insurance company | USD $28,099 | | 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 $831,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,159 | | Amount paid for insurance broker fees | 28099 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 344 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $35,270 | | 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 $859,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,270 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 744245 |
| Policy instance | 1 |
| Insurance contract or identification number | 744245 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $39,750 | | 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 $907,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,750 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
| Policy contract number | 6361500000 |
| Policy instance | 1 |
| Insurance contract or identification number | 6361500000 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $31,498 | | 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 $674,343 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 ) |
| Policy contract number | 835669 |
| Policy instance | 2 |
| Insurance contract or identification number | 835669 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $3,399 | | 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 | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $55,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
| Policy contract number | 6361500000 |
| Policy instance | 1 |
| Insurance contract or identification number | 6361500000 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $30,835 | | 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 $708,137 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,835 | | Insurance broker organization code? | 3 | | Insurance broker name | JOSEPH H. LEE |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 ) |
| Policy contract number | 835669 |
| Policy instance | 2 |
| Insurance contract or identification number | 835669 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $741 | | 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 | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $6,105 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $741 | | Insurance broker organization code? | 1 | | Insurance broker name | JOSEPH H. LEE |
|
