TENACRE FOUNDATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TENACRE FOUNDATION HEALTH BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 152 |
| Total of all active and inactive participants | 2022-07-01 | 152 |
| Total participants | 2022-07-01 | 152 |
| 2021: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 152 |
| Total of all active and inactive participants | 2021-07-01 | 152 |
| Total participants | 2021-07-01 | 152 |
| 2020: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 157 |
| Total of all active and inactive participants | 2020-07-01 | 157 |
| Total participants | 2020-07-01 | 157 |
| 2019: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 161 |
| Total of all active and inactive participants | 2019-07-01 | 161 |
| Total participants | 2019-07-01 | 161 |
| 2018: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 145 |
| Total of all active and inactive participants | 2018-07-01 | 145 |
| Total participants | 2018-07-01 | 145 |
| 2017: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 124 |
| Total of all active and inactive participants | 2017-07-01 | 124 |
| Total participants | 2017-07-01 | 124 |
| 2016: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 109 |
| Total of all active and inactive participants | 2016-07-01 | 109 |
| Total participants | 2016-07-01 | 109 |
| 2015: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 109 |
| Total of all active and inactive participants | 2015-07-01 | 109 |
| Total participants | 2015-07-01 | 109 |
| 2014: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 98 |
| Total of all active and inactive participants | 2014-07-01 | 98 |
| Total participants | 2014-07-01 | 98 |
| 2013: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 109 |
| Total of all active and inactive participants | 2013-07-01 | 109 |
| Total participants | 2013-07-01 | 109 |
| 2012: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 113 |
| Total of all active and inactive participants | 2012-07-01 | 113 |
| Total participants | 2012-07-01 | 113 |
| 2011: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 108 |
| Total of all active and inactive participants | 2011-07-01 | 108 |
| Total participants | 2011-07-01 | 108 |
| 2010: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-07-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 102 |
| Total of all active and inactive participants | 2010-07-01 | 102 |
| 2009: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 101 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 101 |
| 2022: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Submission has been amended | No |
| 2010-07-01 | This submission is the final filing | No |
| 2010-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-07-01 | Plan is a collectively bargained plan | No |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: TENACRE FOUNDATION HEALTH BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $4,082 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $45,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,082 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,643 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $37,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,643 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $904 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $10,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $2,977 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 2020 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 89 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of fees paid to insurance company | USD $23,003 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $153,356 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $3,452 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $38,357 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,452 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 2020 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 97 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $20,452 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $136,345 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,452 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | MEDICAL COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $3,046 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $33,841 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,046 | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $12,569 | | Total amount of fees paid to insurance company | USD $2,704 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $260,609 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $2,363 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $26,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-07-01 | | Total amount of commissions paid to insurance broker | USD $2,024 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $22,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,024 | | Insurance broker organization code? | 3 | | Insurance broker name | PAULA P ASH |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2015-05-01 | | Insurance policy end date | 2016-04-30 | | Total amount of commissions paid to insurance broker | USD $16,166 | | Total amount of fees paid to insurance company | USD $3,874 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $293,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,166 | | Amount paid for insurance broker fees | 3874 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | EMERSON REID LLC |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $10,576 | | Total amount of fees paid to insurance company | USD $4,420 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $288,560 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4420 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $10,576 | | Insurance broker name | PAULA P ASH |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-07-01 | | Total amount of commissions paid to insurance broker | USD $1,934 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $21,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,934 | | Insurance broker organization code? | 3 | | Insurance broker name | PAULA P ASH |
|
| OXFORD HEALTH PLANS NJ, INC. (National Association of Insurance Commissioners NAIC id number: 95506 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $15,556 | | Total amount of fees paid to insurance company | USD $3,495 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $245,379 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,186 | | Amount paid for insurance broker fees | 2832 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | EMERSON REID LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-07-01 | | Total amount of commissions paid to insurance broker | USD $2,141 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC. DEATH & DISMEMB. | | Welfare Benefit Premiums Paid to Carrier | USD $23,790 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,141 | | Insurance broker organization code? | 3 | | Insurance broker name | PAULA P ASH |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,057 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $22,860 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,057 | | Insurance broker organization code? | 3 | | Insurance broker name | PAULA J ASH |
|
| OXFORD HEALTH PLANS NJ, INC. (National Association of Insurance Commissioners NAIC id number: 95506 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $13,364 | | Total amount of fees paid to insurance company | USD $3,484 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $240,954 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,521 | | Amount paid for insurance broker fees | 3484 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | PAULA J ASH |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX200022 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX200022 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $2,016 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $23,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH PLANS NJ, INC. (National Association of Insurance Commissioners NAIC id number: 95506 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $14,123 | | Total amount of fees paid to insurance company | USD $4,056 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $244,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH PLANS NJ, INC. (National Association of Insurance Commissioners NAIC id number: 95506 ) |
| Policy contract number | TF7609 |
| Policy instance | 2 |
| Insurance contract or identification number | TF7609 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $10,437 | | Total amount of fees paid to insurance company | USD $4,287 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $214,175 |
|
| GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 ) |
| Policy contract number | 59374 |
| Policy instance | 1 |
| Insurance contract or identification number | 59374 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $685 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ADD | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,673 |
|
