APPLE HEALTH CONSORTIUM INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan APPLE HEALTH CONSORTIUM MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2022: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 41 |
| Total of all active and inactive participants | 2022-04-01 | 41 |
| 2021: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-04-01 | 285 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 232 |
| Total of all active and inactive participants | 2021-04-01 | 232 |
| 2020: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 271 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 285 |
| Total of all active and inactive participants | 2020-04-01 | 285 |
| 2019: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 271 |
| Total of all active and inactive participants | 2019-04-01 | 271 |
| 2018: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 241 |
| Total of all active and inactive participants | 2018-04-01 | 241 |
| 2017: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 244 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 210 |
| Total of all active and inactive participants | 2017-04-01 | 210 |
| 2016: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 290 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 244 |
| Total of all active and inactive participants | 2016-04-01 | 244 |
| 2015: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 315 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 290 |
| Total of all active and inactive participants | 2015-04-01 | 290 |
| 2014: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 305 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 315 |
| Total of all active and inactive participants | 2014-04-01 | 315 |
| 2013: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 281 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 305 |
| Total of all active and inactive participants | 2013-04-01 | 305 |
| 2012: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 295 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 281 |
| Total of all active and inactive participants | 2012-04-01 | 281 |
| 2011: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 284 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 295 |
| Total of all active and inactive participants | 2011-04-01 | 295 |
| 2010: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 304 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 284 |
| Total of all active and inactive participants | 2010-04-01 | 284 |
| 2009: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 294 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 304 |
| Total of all active and inactive participants | 2009-04-01 | 304 |
| 2022: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2022 form 5500 responses |
|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2021 form 5500 responses |
|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: APPLE HEALTH CONSORTIUM MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 3 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $4,599 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $106,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,599 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 2 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $16,660 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $492,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,660 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 1 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $59,382 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,675,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $59,382 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 1 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $73,708 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,165,345 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $73,708 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 2 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $22,659 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $667,425 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,659 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 3 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $5,424 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $129,721 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,424 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 5 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $1,771 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,180 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,771 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 4 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $6,663 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $195,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,663 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) |
| Policy contract number | 851T6 |
| Policy instance | 3 |
| Insurance contract or identification number | 851T6 | | Number of Individuals Covered | 286 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $20,175 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $613,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,175 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0910854 |
| Policy instance | 2 |
| Insurance contract or identification number | 0910854 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,534 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $103,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,534 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0242005 |
| Policy instance | 1 |
| Insurance contract or identification number | 0242005 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $114,839 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,744,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $114,839 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0242005 |
| Policy instance | 2 |
| Insurance contract or identification number | 0242005 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $10,587 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $552,851 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,587 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | AH15410 |
| Policy instance | 1 |
| Insurance contract or identification number | AH15410 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $90,516 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,203,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $90,516 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | AH15410 |
| Policy instance | 1 |
| Insurance contract or identification number | AH15410 | | Number of Individuals Covered | 241 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $117,263 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,808,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $117,263 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | AH15410 |
| Policy instance | 1 |
| Insurance contract or identification number | AH15410 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $110,516 | | Total amount of fees paid to insurance company | USD $15,780 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,831,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $110,516 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BONUS, ADMIN SERVICES, NON-MONETARY PAYMENT | | Insurance broker organization code? | 3 | | Insurance broker name | THE LEFF COMPANY INC. |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 290 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $20,978 | | Total amount of fees paid to insurance company | USD $165,651 | | Welfare Benefit Premiums Paid to Carrier | USD $258,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,978 | | Amount paid for insurance broker fees | 165651 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR | | Insurance broker organization code? | 5 | | Insurance broker name | THE LOOMIS COMPANY |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 315 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $17,742 | | Total amount of fees paid to insurance company | USD $145,843 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $218,814 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,742 | | Amount paid for insurance broker fees | 145843 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR | | Insurance broker organization code? | 5 | | Insurance broker name | THE LOOMIS COMPANY |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 305 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $15,795 | | Total amount of fees paid to insurance company | USD $139,276 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $194,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,795 | | Amount paid for insurance broker fees | 139276 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR | | Insurance broker organization code? | 5 | | Insurance broker name | THE LOOMIS COMPANY |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $13,673 | | Total amount of fees paid to insurance company | USD $147,154 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $182,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,673 | | Amount paid for insurance broker fees | 147154 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR | | Insurance broker organization code? | 5 | | Insurance broker name | THE LOOMIS COMPANY |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $13,998 | | Total amount of fees paid to insurance company | USD $119,227 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $185,635 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | PF002875 |
| Policy instance | 1 |
| Insurance contract or identification number | PF002875 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $12,556 | | Total amount of fees paid to insurance company | USD $100,865 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $167,617 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,556 | | Amount paid for insurance broker fees | 100865 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR | | Insurance broker organization code? | 5 | | Insurance broker name | THE LOOMIS COMPANY |
|
