EDGAR SNYDER & ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN
401k plan membership statisitcs for EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2021: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 106 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 0 |
| Total of all active and inactive participants | 2021-09-01 | 108 |
| 2020: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 110 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 111 |
| 2019: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 119 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 119 |
| 2018: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 118 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 123 |
| 2017: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 123 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 127 |
| 2016: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 122 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 127 |
| 2015: EDGAR SNYDER & ASSOCIATES, LLC HEALTH AND WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 146 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 9 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 155 |
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00162;800-806 |
| Policy instance | 8 |
| Insurance contract or identification number | 00162;800-806 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $8,686 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $299,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,686 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620NC0 |
| Policy instance | 1 |
| Insurance contract or identification number | 001620NC0 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $41 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;302-309 |
| Policy instance | 2 |
| Insurance contract or identification number | 001620;302-309 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $28,781 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $983,078 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,781 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 3 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $2,881 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,881 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620;NN0-NN7 |
| Policy instance | 4 |
| Insurance contract or identification number | 001620;NN0-NN7 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $8,079 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,424 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,079 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 5 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $4,329 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability 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 $4,329 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 6 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $1,456 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $1,456 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;904-908 |
| Policy instance | 7 |
| Insurance contract or identification number | 001620;904-908 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $65 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $2,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $65 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620NC0 |
| Policy instance | 1 |
| Insurance contract or identification number | 001620NC0 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $113 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $113 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;302-309 |
| Policy instance | 2 |
| Insurance contract or identification number | 001620;302-309 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $25,249 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $878,029 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,249 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 3 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $2,853 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,853 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620;NN0-NN7 |
| Policy instance | 4 |
| Insurance contract or identification number | 001620;NN0-NN7 | | Number of Individuals Covered | 243 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $7,428 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,692 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,428 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 5 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $4,329 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability 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 $4,329 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 6 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $1,436 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $1,436 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;904-908 |
| Policy instance | 7 |
| Insurance contract or identification number | 001620;904-908 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $556 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $18,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $556 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00162;800-806 |
| Policy instance | 8 |
| Insurance contract or identification number | 00162;800-806 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $7,341 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $255,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,341 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;302-316 |
| Policy instance | 2 |
| Insurance contract or identification number | 001620;302-316 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $25,991 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $873,366 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,991 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 3 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $2,921 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,921 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620;NN0-NN7 |
| Policy instance | 4 |
| Insurance contract or identification number | 001620;NN0-NN7 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $8,323 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,287 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,323 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 5 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $4,414 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability 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 $4,414 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 6 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $1,527 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $1,527 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00162;800-812 |
| Policy instance | 8 |
| Insurance contract or identification number | 00162;800-812 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $8,031 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $266,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,031 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620NC0 |
| Policy instance | 1 |
| Insurance contract or identification number | 001620NC0 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $171 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $171 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;904-908 |
| Policy instance | 7 |
| Insurance contract or identification number | 001620;904-908 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $996 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $28,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $996 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00162;800-812 |
| Policy instance | 8 |
| Insurance contract or identification number | 00162;800-812 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $8,964 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $297,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,964 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620NC0 |
| Policy instance | 1 |
| Insurance contract or identification number | 001620NC0 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $299 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $299 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 3 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $4,228 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,228 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;302-308 |
| Policy instance | 2 |
| Insurance contract or identification number | 001620;302-308 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $25,509 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $842,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,509 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620;NN0-NN7 |
| Policy instance | 4 |
| Insurance contract or identification number | 001620;NN0-NN7 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $8,419 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $96,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,419 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 5 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $5,508 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability 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 $5,508 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 756875 |
| Policy instance | 6 |
| Insurance contract or identification number | 756875 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $2,042 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $2,042 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;904-908 |
| Policy instance | 7 |
| Insurance contract or identification number | 001620;904-908 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $1,205 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $44,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,205 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620NC0 |
| Policy instance | 1 |
| Insurance contract or identification number | 001620NC0 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $287 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620;302-308 |
| Policy instance | 2 |
| Insurance contract or identification number | 001620;302-308 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $26,445 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $901,708 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 137159 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 137159 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $2,022 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $28,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620;NN0-NN7 |
| Policy instance | 4 |
| Insurance contract or identification number | 001620;NN0-NN7 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $9,533 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $101,227 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 110990 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 110990 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $3,816 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G 159156 |
| Policy instance | 6 |
| Insurance contract or identification number | G 159156 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $1,619 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620904 |
| Policy instance | 7 |
| Insurance contract or identification number | 001620904 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $48 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00162;800-805 |
| Policy instance | 8 |
| Insurance contract or identification number | 00162;800-805 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $10,112 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPO | | Welfare Benefit Premiums Paid to Carrier | USD $320,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 182901 |
| Policy instance | 9 |
| Insurance contract or identification number | VG 182901 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $747 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,466 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFESOLUTIONS (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | 00000 |
| Policy instance | 10 |
| Insurance contract or identification number | 00000 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EAP | | Welfare Benefit Premiums Paid to Carrier | USD $2,789 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 001620 & SUBS |
| Policy instance | 2 |
| Insurance contract or identification number | 001620 & SUBS | | Number of Individuals Covered | 183 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $29,844 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $994,814 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,844 | | Insurance broker organization code? | 3 | | Insurance broker name | EMERSON REID & CO. |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 137159 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 137159 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $2,309 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $30,538 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,309 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VG 182901 |
| Policy instance | 4 |
| Insurance contract or identification number | VG 182901 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $433 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BASIC LIFE, DEPENDANT LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $4,294 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $433 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 110990 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 110990 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $4,272 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,015 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,272 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G 159156 |
| Policy instance | 6 |
| Insurance contract or identification number | G 159156 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $1,667 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,667 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
| Policy contract number | 001620 & SUBS |
| Policy instance | 1 |
| Insurance contract or identification number | 001620 & SUBS | | Number of Individuals Covered | 289 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $8,282 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,282 | | Insurance broker organization code? | 3 | | Insurance broker name | EMERSON REID & CO. |
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