PROFESSIONAL BUILDING SYSTEMS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN
Measure | Date | Value |
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2021: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 234 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 236 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 236 |
2020: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 229 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 234 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 234 |
2019: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 229 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 229 |
2018: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 207 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 225 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 225 |
2017: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 0 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 207 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 207 |
2016: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 278 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 231 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 231 |
2015: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 268 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 278 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 278 |
2014: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 242 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 268 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 268 |
2013: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 229 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 242 |
Total of all active and inactive participants | 2013-01-01 | 242 |
2012: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 226 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 229 |
Total of all active and inactive participants | 2012-01-01 | 229 |
Total participants | 2012-01-01 | 229 |
2011: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 208 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 226 |
Total of all active and inactive participants | 2011-01-01 | 226 |
Total participants | 2011-01-01 | 226 |
2010: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 208 |
Total of all active and inactive participants | 2010-01-01 | 208 |
Total participants | 2010-01-01 | 208 |
2009: PROFESSIONAL BUILDING SYSTEMS, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 148 |
Total of all active and inactive participants | 2009-01-01 | 148 |
Total participants | 2009-01-01 | 148 |
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 4184 |
Policy instance | 4 |
Insurance contract or identification number | 4184 | Number of Individuals Covered | 453 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,740 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,740 | Insurance broker organization code? | 3 |
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GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 ) |
Policy contract number | 10117915 |
Policy instance | 3 |
Insurance contract or identification number | 10117915 | Number of Individuals Covered | 439 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $40,900 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,768,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,900 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 805550G |
Policy instance | 5 |
Insurance contract or identification number | 805550G | Number of Individuals Covered | 334 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $30,671 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D & SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $205,236 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,671 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 1 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 458 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,742 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0465880 |
Policy instance | 2 |
Insurance contract or identification number | R0465880 | Number of Individuals Covered | 35 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $352 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $13,982 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $352 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 1 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 458 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $74,528 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 ) |
Policy contract number | 10117915 |
Policy instance | 4 |
Insurance contract or identification number | 10117915 | Number of Individuals Covered | 439 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $34,566 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,728,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,566 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0009641524 |
Policy instance | 3 |
Insurance contract or identification number | 0009641524 | Number of Individuals Covered | 11 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $63 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $2,476 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63 | Insurance broker organization code? | 3 |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 4184 |
Policy instance | 5 |
Insurance contract or identification number | 4184 | Number of Individuals Covered | 453 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,740 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,396 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,740 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 805550G |
Policy instance | 6 |
Insurance contract or identification number | 805550G | Number of Individuals Covered | 334 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $17,257 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D & SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $114,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,257 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0465880 |
Policy instance | 2 |
Insurance contract or identification number | R0465880 | Number of Individuals Covered | 35 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $301 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,959 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $301 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0465880 |
Policy instance | 3 |
Insurance contract or identification number | R0465880 | Number of Individuals Covered | 39 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $323 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $12,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $323 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0009641524 |
Policy instance | 4 |
Insurance contract or identification number | 0009641524 | Number of Individuals Covered | 14 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $76 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76 | Insurance broker organization code? | 3 |
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GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 ) |
Policy contract number | 10117915 |
Policy instance | 5 |
Insurance contract or identification number | 10117915 | Number of Individuals Covered | 377 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $7,295 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $364,763 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,295 | Insurance broker organization code? | 3 |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 4184 |
Policy instance | 6 |
Insurance contract or identification number | 4184 | Number of Individuals Covered | 461 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,772 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,723 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,772 | Insurance broker organization code? | 3 |
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GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 10117915 |
Policy instance | 7 |
Insurance contract or identification number | 10117915 | Number of Individuals Covered | 427 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $34,198 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,709,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,198 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0284722 |
Policy instance | 1 |
Insurance contract or identification number | 0284722 | Number of Individuals Covered | 335 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $22,185 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $148,884 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,185 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 2 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 474 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $106,136 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 ) |
Policy contract number | 117915 |
Policy instance | 5 |
Insurance contract or identification number | 117915 | Number of Individuals Covered | 6 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $624 | Total amount of fees paid to insurance company | USD $19 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,801 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $624 | Amount paid for insurance broker fees | 19 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0465880 |
Policy instance | 3 |
Insurance contract or identification number | R0465880 | Number of Individuals Covered | 40 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $372 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $14,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $372 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0284722 |
Policy instance | 1 |
Insurance contract or identification number | 0284722 | Number of Individuals Covered | 318 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $18,740 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $139,218 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,740 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0009641524 |
Policy instance | 4 |
Insurance contract or identification number | 0009641524 | Number of Individuals Covered | 14 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $89 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,496 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $89 | Insurance broker organization code? | 3 |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 4184 |
Policy instance | 6 |
Insurance contract or identification number | 4184 | Number of Individuals Covered | 446 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,553 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,529 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,553 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 2 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 471 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
Policy contract number | 117915 |
Policy instance | 7 |
Insurance contract or identification number | 117915 | Number of Individuals Covered | 431 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $48,708 | Total amount of fees paid to insurance company | USD $1,461 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,623,590 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $48,708 | Amount paid for insurance broker fees | 1461 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0284722 |
Policy instance | 1 |
Insurance contract or identification number | 0284722 | Number of Individuals Covered | 301 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $17,063 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $112,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,063 | Insurance broker organization code? | 3 | Insurance broker name | PEGGY A REINARD |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 3 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 372 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,003 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0009641524 |
Policy instance | 5 |
Insurance contract or identification number | 0009641524 | Number of Individuals Covered | 20 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $83 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $83 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 4184 |
Policy instance | 7 |
Insurance contract or identification number | 4184 | Number of Individuals Covered | 399 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,453 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,453 | Insurance broker organization code? | 3 | Insurance broker name | PEGGY A REINARD |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0465880 |
Policy instance | 4 |
Insurance contract or identification number | R0465880 | Number of Individuals Covered | 45 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $335 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $13,288 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $335 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES |
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GEISINGER QUALITY OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 12743 ) |
Policy contract number | 117915 |
Policy instance | 6 |
Insurance contract or identification number | 117915 | Number of Individuals Covered | 417 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $48,367 | Total amount of fees paid to insurance company | USD $1,451 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,612,236 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $48,367 | Amount paid for insurance broker fees | 1451 | Insurance broker organization code? | 3 | Insurance broker name | PURDY INSURANCE AGENCY |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000006227 |
Policy instance | 2 |
Insurance contract or identification number | 0000006227 | Number of Individuals Covered | 63 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $624 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,183 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $575 | Insurance broker organization code? | 3 | Insurance broker name | CUSTOM BENEFIT PROGRAMS |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000006227 |
Policy instance | 2 |
Insurance contract or identification number | 0000006227 | Number of Individuals Covered | 62 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,091 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,885 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $248 | Insurance broker organization code? | 3 | Insurance broker name | KIRK MYERS |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00525587 |
Policy instance | 5 |
Insurance contract or identification number | 00525587 | Number of Individuals Covered | 201 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $33,200 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,209,400 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,200 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211609 |
Policy instance | 4 |
Insurance contract or identification number | 211609 | Number of Individuals Covered | 134 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-11-01 | Total amount of commissions paid to insurance broker | USD $5,201 | Total amount of fees paid to insurance company | USD $41 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $34,671 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,201 | Amount paid for insurance broker fees | 41 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 3 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 426 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $63,099 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211608 |
Policy instance | 1 |
Insurance contract or identification number | 211608 | Number of Individuals Covered | 278 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-11-01 | Total amount of commissions paid to insurance broker | USD $7,464 | Total amount of fees paid to insurance company | USD $100 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $79,737 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,464 | Amount paid for insurance broker fees | 100 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211608 |
Policy instance | 1 |
Insurance contract or identification number | 211608 | Number of Individuals Covered | 268 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-11-01 | Total amount of commissions paid to insurance broker | USD $7,290 | Total amount of fees paid to insurance company | USD $579 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $77,180 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,290 | Amount paid for insurance broker fees | 579 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC. |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 5 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 359 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 1804480000 |
Policy instance | 2 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 1 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $81 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,223 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 1804480000 |
Policy instance | 3 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 387 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $27,763 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,110,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,763 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 077827 |
Policy instance | 6 |
Insurance contract or identification number | 077827 | Number of Individuals Covered | 342 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $263 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $263 | Insurance broker organization code? | 3 | Insurance broker name | EMERSON REID & CO. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211609 |
Policy instance | 7 |
Insurance contract or identification number | 211609 | Number of Individuals Covered | 144 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-11-01 | Total amount of commissions paid to insurance broker | USD $4,811 | Total amount of fees paid to insurance company | USD $240 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $32,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,811 | Amount paid for insurance broker fees | 240 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000006227 |
Policy instance | 4 |
Insurance contract or identification number | 0000006227 | Number of Individuals Covered | 62 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,445 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,817 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $479 | Insurance broker organization code? | 3 | Insurance broker name | KIRK MYERS |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211609 |
Policy instance | 7 |
Insurance contract or identification number | 211609 | Number of Individuals Covered | 150 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-11-01 | Total amount of commissions paid to insurance broker | USD $5,160 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $31,729 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,160 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 077827 |
Policy instance | 6 |
Insurance contract or identification number | 077827 | Number of Individuals Covered | 341 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $204 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,770 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $128 | Insurance broker organization code? | 3 | Insurance broker name | MELISSA A. WEVODAU |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 16275 |
Policy instance | 5 |
Insurance contract or identification number | 16275 | Number of Individuals Covered | 365 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $57,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000006227 |
Policy instance | 4 |
Insurance contract or identification number | 0000006227 | Number of Individuals Covered | 62 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,179 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,034 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $496 | Insurance broker organization code? | 3 | Insurance broker name | KIRK MYERS |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 1804480000 |
Policy instance | 2 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 211608 |
Policy instance | 1 |
Insurance contract or identification number | 211608 | Number of Individuals Covered | 242 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-11-01 | Total amount of commissions paid to insurance broker | USD $8,547 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $76,390 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,547 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC. |
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HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 1804480000 |
Policy instance | 3 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 389 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $27,354 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,089,316 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,354 | Insurance broker organization code? | 3 | Insurance broker name | SAUVE CONSULTING GROUP INC |
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UNITED CONCORDIA COMPANIES, INC. (National Association of Insurance Commissioners NAIC id number: 89070 ) |
Policy contract number | 847176-001 |
Policy instance | 6 |
Insurance contract or identification number | 847176-001 | Number of Individuals Covered | 327 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Dental Insurance Welfare Benefit | Yes |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | V255155 |
Policy instance | 5 |
Insurance contract or identification number | V255155 | Number of Individuals Covered | 192 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $6,723 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL. DEPENDENT LIFE | Welfare Benefit Premiums Paid to Carrier | USD $33,617 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,723 | Insurance broker organization code? | 3 | Insurance broker name | TRUMAN R. PURDY |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G255159 |
Policy instance | 4 |
Insurance contract or identification number | G255159 | Number of Individuals Covered | 229 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $4,074 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $34,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,074 | Insurance broker organization code? | 3 | Insurance broker name | TRUMAN R. PURDY |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 1804480000 |
Policy instance | 3 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 369 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,665 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,291 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,649 | Insurance broker organization code? | 3 | Insurance broker name | ERC - SAUVE CONSULTING GROUP INC |
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HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 1804480000 |
Policy instance | 2 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 408 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $22,287 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $926,549 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,638 | Insurance broker organization code? | 3 | Insurance broker name | ERC - SAUVE CONSULTING GROUP INC |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 077827 |
Policy instance | 1 |
Insurance contract or identification number | 077827 | Number of Individuals Covered | 327 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $197 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,373 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35 | Insurance broker organization code? | 3 | Insurance broker name | WEVODAU, MELISSA A. |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 077827 |
Policy instance | 1 |
Insurance contract or identification number | 077827 | Number of Individuals Covered | 319 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $204 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA COMPANIES, INC. (National Association of Insurance Commissioners NAIC id number: 89070 ) |
Policy contract number | 847176-001 |
Policy instance | 6 |
Insurance contract or identification number | 847176-001 | Number of Individuals Covered | 302 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | V255155 |
Policy instance | 5 |
Insurance contract or identification number | V255155 | Number of Individuals Covered | 111 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $7,440 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL. DEPENDENT LIFE | Welfare Benefit Premiums Paid to Carrier | USD $37,199 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | G255159 |
Policy instance | 4 |
Insurance contract or identification number | G255159 | Number of Individuals Covered | 226 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,444 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $41,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 1804480000 |
Policy instance | 3 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 1 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $133 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,324 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 1804480000 |
Policy instance | 2 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 386 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $19,530 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $781,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 077827 |
Policy instance | 1 |
Insurance contract or identification number | 077827 | Number of Individuals Covered | 321 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $182 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,468 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA COMPANIES, INC. (National Association of Insurance Commissioners NAIC id number: 89070 ) |
Policy contract number | 847176-001 |
Policy instance | 6 |
Insurance contract or identification number | 847176-001 | Number of Individuals Covered | 290 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | V255155 |
Policy instance | 5 |
Insurance contract or identification number | V255155 | Number of Individuals Covered | 101 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,795 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL. DEPENDENT LIFE | Welfare Benefit Premiums Paid to Carrier | USD $33,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
Policy contract number | G255159 |
Policy instance | 4 |
Insurance contract or identification number | G255159 | Number of Individuals Covered | 208 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,074 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $35,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 1804480000 |
Policy instance | 3 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 13 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $980 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,484 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 1804480000 |
Policy instance | 2 |
Insurance contract or identification number | 1804480000 | Number of Individuals Covered | 356 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $24,326 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $693,019 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|