KARNS PRIME & FANCY FOOD, LTD. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KARNS PRIME & FANCY FOOD LTD WELFARE PLAN
| Measure | Date | Value |
|---|
| 2017: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
| Total of all active and inactive participants | 2017-03-01 | 0 |
| 2016: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 257 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 264 |
| Number of retired or separated participants receiving benefits | 2016-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 0 |
| Total of all active and inactive participants | 2016-03-01 | 264 |
| 2015: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 316 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 257 |
| Number of retired or separated participants receiving benefits | 2015-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-03-01 | 0 |
| Total of all active and inactive participants | 2015-03-01 | 257 |
| 2014: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 324 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 316 |
| Number of retired or separated participants receiving benefits | 2014-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-03-01 | 0 |
| Total of all active and inactive participants | 2014-03-01 | 316 |
| 2013: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 287 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 324 |
| Number of retired or separated participants receiving benefits | 2013-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-03-01 | 0 |
| Total of all active and inactive participants | 2013-03-01 | 324 |
| 2012: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 295 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 287 |
| Number of retired or separated participants receiving benefits | 2012-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-03-01 | 0 |
| Total of all active and inactive participants | 2012-03-01 | 287 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-03-01 | 0 |
| Total participants | 2012-03-01 | 287 |
| Number of participants with account balances | 2012-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-03-01 | 0 |
| 2011: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 297 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 295 |
| Total of all active and inactive participants | 2011-03-01 | 295 |
| Total participants | 2011-03-01 | 295 |
| 2010: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 332 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 297 |
| Total of all active and inactive participants | 2010-03-01 | 297 |
| Total participants | 2010-03-01 | 297 |
| 2009: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 332 |
| Total of all active and inactive participants | 2009-03-01 | 332 |
| Total participants | 2009-03-01 | 332 |
| 2017: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Submission has been amended | No |
| 2017-03-01 | This submission is the final filing | Yes |
| 2017-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-03-01 | Plan is a collectively bargained plan | No |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: KARNS PRIME & FANCY FOOD LTD WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00525554 |
| Policy instance | 4 |
| Insurance contract or identification number | 00525554 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $17,910 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,910 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL, INC. |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 3854 |
| Policy instance | 3 |
| Insurance contract or identification number | 3854 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $324 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $324 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5473446 |
| Policy instance | 2 |
| Insurance contract or identification number | 5473446 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $7,676 | | 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 | Yes | | 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 $76,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,676 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00525554 |
| Policy instance | 1 |
| Insurance contract or identification number | 00525554 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $21,367 | | 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 | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,367 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | NONE | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL INC |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 3854 |
| Policy instance | 5 |
| Insurance contract or identification number | 3854 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2015-11-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $75 | | Total amount of fees paid to insurance company | USD $1,141 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75 | | Amount paid for insurance broker fees | 1141 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICE FEES RISKS AND OTHER CONTINGENCIES | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
| Policy contract number | 00525554 |
| Policy instance | 4 |
| Insurance contract or identification number | 00525554 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $19,496 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,496 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL INC. |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5473446 |
| Policy instance | 3 |
| Insurance contract or identification number | 5473446 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $7,501 | | Total amount of fees paid to insurance company | USD $1,532 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,501 | | Amount paid for insurance broker fees | 1532 | | Additional information about fees paid to insurance broker | BONUS COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $463 | | Total amount of fees paid to insurance company | USD $615 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $463 | | Amount paid for insurance broker fees | 615 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES FEES RISKS OR OTHER CONTINGENCIES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
| Policy contract number | 00525554 |
| Policy instance | 1 |
| Insurance contract or identification number | 00525554 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $24,661 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,661 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00401855 |
| Policy instance | 3 |
| Insurance contract or identification number | 00401855 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $2,986 | | Total amount of fees paid to insurance company | USD $97 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,760 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,986 | | Amount paid for insurance broker fees | 97 | | Additional information about fees paid to insurance broker | BONUS COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $369 | | Total amount of fees paid to insurance company | USD $2,635 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $369 | | Amount paid for insurance broker fees | 2635 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES FEES RISKS OR OTHER CONTINGENCIES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
| Policy contract number | 1086630000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1086630000 | | Number of Individuals Covered | 316 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $39,700 | | Total amount of fees paid to insurance company | USD $1,500 | | Are there contracts with allocated funds for individual policies? | Yes | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,134,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,700 | | Amount paid for insurance broker fees | 1500 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00401855 |
| Policy instance | 3 |
| Insurance contract or identification number | 00401855 | | Number of Individuals Covered | 291 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $3,009 | | Total amount of fees paid to insurance company | USD $96 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,299 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,009 | | Amount paid for insurance broker fees | 96 | | Additional information about fees paid to insurance broker | BONUS COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $474 | | Total amount of fees paid to insurance company | USD $813 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $474 | | Amount paid for insurance broker fees | 813 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES FEES RISKS OR OTHER CONTINGENCIES | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
| Policy contract number | 1086630000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1086630000 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $38,728 | | Are there contracts with allocated funds for individual policies? | Yes | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,106,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $38,728 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $334 | | Total amount of fees paid to insurance company | USD $897 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $334 | | Amount paid for insurance broker fees | 897 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICE RISKS / OTHER CONTINGENCIES | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00401855 |
| Policy instance | 3 |
| Insurance contract or identification number | 00401855 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-11-30 | | Total amount of commissions paid to insurance broker | USD $2,937 | | Total amount of fees paid to insurance company | USD $2,009 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,937 | | Amount paid for insurance broker fees | 2009 | | Additional information about fees paid to insurance broker | BONUS COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
| Policy contract number | 1086630000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1086630000 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $28,651 | | Are there contracts with allocated funds for individual policies? | Yes | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,146,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,651 | | Insurance broker organization code? | 3 | | Insurance broker name | COMMONWEALTH FINANCIAL GROUP |
|
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
| Policy contract number | 1086630000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1086630000 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $30,501 | | Are there contracts with allocated funds for individual policies? | Yes | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,220,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $471 | | Total amount of fees paid to insurance company | USD $817 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00401855 |
| Policy instance | 3 |
| Insurance contract or identification number | 00401855 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2010-12-01 | | Insurance policy end date | 2011-11-30 | | Total amount of commissions paid to insurance broker | USD $2,924 | | Total amount of fees paid to insurance company | USD $2,244 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,572 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 1914 |
| Policy instance | 2 |
| Insurance contract or identification number | 1914 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $361 | | Total amount of fees paid to insurance company | USD $1,108 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
| Policy contract number | 1086630000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1086630000 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2009-11-01 | | Insurance policy end date | 2010-10-31 | | Total amount of commissions paid to insurance broker | USD $32,667 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,309,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 401855 |
| Policy instance | 3 |
| Insurance contract or identification number | 401855 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2009-12-01 | | Insurance policy end date | 2010-11-30 | | Total amount of commissions paid to insurance broker | USD $2,874 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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