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CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameCRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN
Plan identification number 501

CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

TEMPORARY HOUSING, INC. CRS TEMPORARY HOUSING has sponsored the creation of one or more 401k plans.

Company Name:TEMPORARY HOUSING, INC. CRS TEMPORARY HOUSING
Employer identification number (EIN):208134444
NAIC Classification:531390
NAIC Description:Other Activities Related to Real Estate

Additional information about TEMPORARY HOUSING, INC. CRS TEMPORARY HOUSING

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1992-09-16
Company Identification Number: V64364
Legal Registered Office Address: 3375-A CAPITAL CIRCLE NE

TALLAHASSEE

32308

More information about TEMPORARY HOUSING, INC. CRS TEMPORARY HOUSING

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01LINDA HOOLIHAN2023-09-28
5012021-05-01LINDA HOOLIHAN2022-09-20
5012020-05-01LINDA HOOLIHAN2021-09-14
5012019-05-01LINDA HOOLIHAN2020-10-08
5012018-05-01LINDA HOOLIHAN2019-10-30
5012017-05-01
5012016-05-01

Plan Statistics for CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN

401k plan membership statisitcs for CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN

Measure Date Value
2022: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01186
Total number of active participants reported on line 7a of the Form 55002022-05-01286
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01286
Number of employers contributing to the scheme2022-05-010
2021: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01149
Total number of active participants reported on line 7a of the Form 55002021-05-01186
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01186
Number of employers contributing to the scheme2021-05-010
2020: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01174
Total number of active participants reported on line 7a of the Form 55002020-05-01149
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01149
Number of employers contributing to the scheme2020-05-010
2019: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01157
Total number of active participants reported on line 7a of the Form 55002019-05-01174
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01174
Number of employers contributing to the scheme2019-05-010
2018: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01110
Total number of active participants reported on line 7a of the Form 55002018-05-01157
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01157
Number of employers contributing to the scheme2018-05-010
2017: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01116
Total number of active participants reported on line 7a of the Form 55002017-05-01113
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01113
2016: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-0199
Total number of active participants reported on line 7a of the Form 55002016-05-01116
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01116

Form 5500 Responses for CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN

2022: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: CRS TEMPORARY HOUSING HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01First time form 5500 has been submittedYes
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number607171
Policy instance 5
Insurance contract or identification number607171
Number of Individuals Covered19
Insurance policy start date2022-10-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $6,531
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $169,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,531
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BJP5
Policy instance 4
Insurance contract or identification numberGLUG0BJP5
Number of Individuals Covered286
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $15,874
Total amount of fees paid to insurance companyUSD $10,187
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $128,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,874
Amount paid for insurance broker fees4937
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number803943BH
Policy instance 3
Insurance contract or identification number803943BH
Number of Individuals Covered80
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $445,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16059 )
Policy contract number803943HNOBH
Policy instance 2
Insurance contract or identification number803943HNOBH
Number of Individuals Covered155
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $644,583
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: 60054 )
Policy contract number803943
Policy instance 1
Insurance contract or identification number803943
Number of Individuals Covered432
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $18,206
Total amount of fees paid to insurance companyUSD $10,883
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $910,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,206
Amount paid for insurance broker fees10883
Additional information about fees paid to insurance broker2022 SIGNATURE MEDICAL/DENTAL RETENTION INCENTIVE RISK
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16059 )
Policy contract number803943HNOBH
Policy instance 2
Insurance contract or identification number803943HNOBH
Number of Individuals Covered194
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $918,853
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: 60054 )
Policy contract number803943
Policy instance 1
Insurance contract or identification number803943
Number of Individuals Covered278
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $11,202
Total amount of fees paid to insurance companyUSD $2,891
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,120
Amount paid for insurance broker fees2891
Additional information about fees paid to insurance broker2021 MEDICAL AND VISION RETENSION INCENTIVE RISK
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BJP5
Policy instance 3
Insurance contract or identification numberGLUG0BJP5
Number of Individuals Covered186
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $7,787
Total amount of fees paid to insurance companyUSD $6,534
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $77,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,251
Amount paid for insurance broker fees3726
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number803943
Policy instance 5
Insurance contract or identification number803943
Number of Individuals Covered149
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $6,890
Total amount of fees paid to insurance companyUSD $6,511
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $68,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,337
Amount paid for insurance broker fees3499
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803943
Policy instance 1
Insurance contract or identification number803943
Number of Individuals Covered220
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,437
Total amount of fees paid to insurance companyUSD $14,347
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,437
Amount paid for insurance broker fees14347
Additional information about fees paid to insurance broker2020 SIGNATURE MEDICAL RETENTION INCENTIVE 2019 PREMIER PRODUCER PROGRAM DIRECT COMPENSATION
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16059 )
Policy contract number803943HNOBH
Policy instance 2
Insurance contract or identification number803943HNOBH
Number of Individuals Covered135
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $33,600
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $623,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees33600
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number922394-000
Policy instance 4
Insurance contract or identification number922394-000
Number of Individuals Covered262
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $9,882
Total amount of fees paid to insurance companyUSD $378
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,882
Amount paid for insurance broker fees378
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number803943BH
Policy instance 3
Insurance contract or identification number803943BH
Number of Individuals Covered58
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $14,362
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $276,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14362
Additional information about fees paid to insurance broker2020 SIGNATURE SPECIALTY RETENTION INCENTIVE RISK DIRECT COMPENSATION
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number922394-000
Policy instance 5
Insurance contract or identification number922394-000
Number of Individuals Covered304
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $7,139
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,139
Amount paid for insurance broker fees0
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number803943BH
Policy instance 4
Insurance contract or identification number803943BH
Number of Individuals Covered50
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $13,371
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13371
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES665
Policy instance 3
Insurance contract or identification numberBENIES665
Number of Individuals Covered46
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEDOC
Welfare Benefit Premiums Paid to CarrierUSD $6,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16059 )
Policy contract number803943HNOBH
Policy instance 2
Insurance contract or identification number803943HNOBH
Number of Individuals Covered178
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $36,026
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $706,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees36026
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803943
Policy instance 1
Insurance contract or identification number803943
Number of Individuals Covered238
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $2,137
Total amount of fees paid to insurance companyUSD $6,411
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,137
Amount paid for insurance broker fees6411
Additional information about fees paid to insurance brokerDIRECT AND INDIRECT COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BJP5
Policy instance 6
Insurance contract or identification numberGLUG0BJP5
Number of Individuals Covered174
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $7,007
Total amount of fees paid to insurance companyUSD $5,593
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $70,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,183
Amount paid for insurance broker fees2569
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10216181
Policy instance 6
Insurance contract or identification number10216181
Number of Individuals Covered155
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $5,851
Total amount of fees paid to insurance companyUSD $1,714
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $58,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,851
Amount paid for insurance broker fees1714
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97433601001
Policy instance 1
Insurance contract or identification number97433601001
Number of Individuals Covered211
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $1,813
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,813
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803943
Policy instance 2
Insurance contract or identification number803943
Number of Individuals Covered231
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $8,843
Total amount of fees paid to insurance companyUSD $7,012
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $211,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,190
Amount paid for insurance broker fees4851
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16059 )
Policy contract number803943HNOBH
Policy instance 3
Insurance contract or identification number803943HNOBH
Number of Individuals Covered151
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $36,678
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $605,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees28874
Additional information about fees paid to insurance brokerDIRECT COMPENSATION BROKER BONUS
Insurance broker organization code?3
FRESHBENIES (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberBENIES665
Policy instance 4
Insurance contract or identification numberBENIES665
Number of Individuals Covered50
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEDOC
Welfare Benefit Premiums Paid to CarrierUSD $5,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BANNER HEALTH AND AETNA HEALTH (National Association of Insurance Commissioners NAIC id number: 16058 )
Policy contract number803943BH
Policy instance 5
Insurance contract or identification number803943BH
Number of Individuals Covered43
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,136
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5874
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number010216181
Policy instance 4
Insurance contract or identification number010216181
Number of Individuals Covered113
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $4,567
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $45,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,567
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBENEFITS AMERICA INSURANCE SERVICES
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract number803943HNO
Policy instance 3
Insurance contract or identification number803943HNO
Number of Individuals Covered121
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $23,379
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $448,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees23379
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS AMERICA INSURANCE SERVICES
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803943
Policy instance 2
Insurance contract or identification number803943
Number of Individuals Covered188
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $6,587
Total amount of fees paid to insurance companyUSD $12,788
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $321,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,587
Amount paid for insurance broker fees12788
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS AMERICA INSURANCE SERVICES
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97433601001
Policy instance 1
Insurance contract or identification number97433601001
Number of Individuals Covered165
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,606
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,606
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameVENBROOK INSURANCE SERVICES

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