SB ONE BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SUSSEX BANK HEALTH AND WELFARE PLAN
Measure | Date | Value |
---|
2020: SUSSEX BANK HEALTH AND WELFARE PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 376 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 0 |
2019: SUSSEX BANK HEALTH AND WELFARE PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 328 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 365 |
Total of all active and inactive participants | 2019-01-01 | 365 |
2018: SUSSEX BANK HEALTH AND WELFARE PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 255 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 328 |
Total of all active and inactive participants | 2018-01-01 | 328 |
2017: SUSSEX BANK HEALTH AND WELFARE PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 131 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 255 |
Total of all active and inactive participants | 2017-01-01 | 255 |
Total participants | 2017-01-01 | 255 |
2016: SUSSEX BANK HEALTH AND WELFARE PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 210 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 131 |
Total of all active and inactive participants | 2016-01-01 | 131 |
Total participants | 2016-01-01 | 131 |
2015: SUSSEX BANK HEALTH AND WELFARE PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 177 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 210 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 210 |
Total participants | 2015-01-01 | 210 |
2014: SUSSEX BANK HEALTH AND WELFARE PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 161 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 177 |
Total of all active and inactive participants | 2014-01-01 | 177 |
Total participants | 2014-01-01 | 177 |
2013: SUSSEX BANK HEALTH AND WELFARE PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 160 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 80 |
Total of all active and inactive participants | 2013-01-01 | 80 |
Total participants | 2013-01-01 | 80 |
2012: SUSSEX BANK HEALTH AND WELFARE PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 160 |
Total of all active and inactive participants | 2012-01-01 | 160 |
Total participants | 2012-01-01 | 160 |
2011: SUSSEX BANK HEALTH AND WELFARE PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 168 |
Total of all active and inactive participants | 2011-01-01 | 168 |
Total participants | 2011-01-01 | 168 |
2010: SUSSEX BANK HEALTH AND WELFARE PLAN 2010 401k membership |
---|
Total participants, beginning-of-year | 2010-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 141 |
Total of all active and inactive participants | 2010-01-01 | 141 |
Total participants | 2010-01-01 | 141 |
2020: SUSSEX BANK HEALTH AND WELFARE PLAN 2020 form 5500 responses |
---|
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | Yes |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: SUSSEX BANK HEALTH AND WELFARE PLAN 2019 form 5500 responses |
---|
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: SUSSEX BANK HEALTH AND WELFARE PLAN 2018 form 5500 responses |
---|
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: SUSSEX BANK HEALTH AND WELFARE PLAN 2017 form 5500 responses |
---|
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: SUSSEX BANK HEALTH AND WELFARE PLAN 2016 form 5500 responses |
---|
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: SUSSEX BANK HEALTH AND WELFARE PLAN 2015 form 5500 responses |
---|
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: SUSSEX BANK HEALTH AND WELFARE PLAN 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: SUSSEX BANK HEALTH AND WELFARE PLAN 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: SUSSEX BANK HEALTH AND WELFARE PLAN 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: SUSSEX BANK HEALTH AND WELFARE PLAN 2011 form 5500 responses |
---|
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2010: SUSSEX BANK HEALTH AND WELFARE PLAN 2010 form 5500 responses |
---|
2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | First time form 5500 has been submitted | Yes |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) |
Policy contract number | E3929486 |
Policy instance | 4 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $199 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 | 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 $3,604 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $199 | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3929486 |
Policy instance | 3 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $1,793 | Total amount of fees paid to insurance company | USD $458 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Long Term Disability Insurance Welfare Benefit | Yes | 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 $18,217 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,793 | Amount paid for insurance broker fees | 458 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00456808 |
Policy instance | 2 |
Insurance contract or identification number | 00456808 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $11,739 | Total amount of fees paid to insurance company | USD $12,152 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $192,766 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,739 | Amount paid for insurance broker fees | 12152 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0242195 |
Policy instance | 1 |
Insurance contract or identification number | 0242195 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $80,610 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | 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 $1,761,976 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $80,610 | Insurance broker organization code? | 3 |
|
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) |
Policy contract number | E3929486 |
Policy instance | 4 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 5 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $554 | Total amount of fees paid to insurance company | USD $11 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,305 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $229 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 11 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3929486 |
Policy instance | 3 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $5,602 | Total amount of fees paid to insurance company | USD $2,905 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,446 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,781 | Amount paid for insurance broker fees | 2790 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00456808 |
Policy instance | 2 |
Insurance contract or identification number | 00456808 | Number of Individuals Covered | 232 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $20,351 | Total amount of fees paid to insurance company | USD $11,138 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $351,444 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,351 | Amount paid for insurance broker fees | 11138 | Insurance broker organization code? | 3 |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SB1407 |
Policy instance | 1 |
Insurance contract or identification number | SB1407 | Number of Individuals Covered | 365 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $127,005 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,828,380 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $127,005 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) |
Policy contract number | E3929486 |
Policy instance | 4 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 5 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,117 | Total amount of fees paid to insurance company | USD $25 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,762 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $441 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 25 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3929486 |
Policy instance | 3 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 33 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $5,239 | Total amount of fees paid to insurance company | USD $4,161 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,601 | Amount paid for insurance broker fees | 4101 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00456808 |
Policy instance | 2 |
Insurance contract or identification number | 00456808 | Number of Individuals Covered | 194 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $19,213 | Total amount of fees paid to insurance company | USD $8,884 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $282,166 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,213 | Amount paid for insurance broker fees | 8884 | Insurance broker organization code? | 3 |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SB1407 |
Policy instance | 1 |
Insurance contract or identification number | SB1407 | Number of Individuals Covered | 328 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $110,334 | Total amount of fees paid to insurance company | USD $3,003 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,381,148 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $110,334 | Amount paid for insurance broker fees | 3003 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) |
Policy contract number | E3929486 |
Policy instance | 4 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 3 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $454 | Total amount of fees paid to insurance company | USD $15 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,602 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $191 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5 | Insurance broker name | EVELYN GARCIA |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3929486 |
Policy instance | 3 |
Insurance contract or identification number | E3929486 | Number of Individuals Covered | 24 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,807 | Total amount of fees paid to insurance company | USD $1,234 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,212 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $587 | Amount paid for insurance broker fees | 1199 | Insurance broker organization code? | 3 | Insurance broker name | PAUL IRWIN ABRAMSON |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00456808 |
Policy instance | 2 |
Insurance contract or identification number | 00456808 | Number of Individuals Covered | 139 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $14,267 | Total amount of fees paid to insurance company | USD $7,976 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $192,319 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,267 | Amount paid for insurance broker fees | 7976 | Insurance broker organization code? | 3 | Insurance broker name | PREFERRED BENEFITS GROUP |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | SB1407 |
Policy instance | 1 |
Insurance contract or identification number | SB1407 | Number of Individuals Covered | 255 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $78,330 | Total amount of fees paid to insurance company | USD $1,325 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,610,367 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $78,330 | Amount paid for insurance broker fees | 1325 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | PREFERRED BENEFITS GROUP, INC. |
|