CONSTELLATION ENERGY GENERATION LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CONSTELLATION HEALTH CARE PROGRAM
| Measure | Date | Value |
|---|
| 2023 : CONSTELLATION HEALTH CARE PROGRAM 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-12-31 | $12,755,604 |
| Total unrealized appreciation/depreciation of assets | 2023-12-31 | $12,755,604 |
| Total transfer of assets from this plan | 2023-12-31 | $21,606,145 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $55,528,101 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $45,680,855 |
| Total income from all sources (including contributions) | 2023-12-31 | $279,449,348 |
| Total loss/gain on sale of assets | 2023-12-31 | $-1,018,879 |
| Total of all expenses incurred | 2023-12-31 | $296,356,713 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $281,450,134 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $238,958,316 |
| Value of total assets at end of year | 2023-12-31 | $558,787,019 |
| Value of total assets at beginning of year | 2023-12-31 | $587,453,283 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $14,906,579 |
| Total interest from all sources | 2023-12-31 | $3,331,026 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-12-31 | $3,670,641 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-12-31 | $1,536,924 |
| Assets. Real estate other than employer real property at end of year | 2023-12-31 | $29,950,549 |
| Assets. Real estate other than employer real property at beginning of year | 2023-12-31 | $34,667,364 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2023-12-31 | $68,117 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2023-12-31 | $47,780 |
| Was this plan covered by a fidelity bond | 2023-12-31 | Yes |
| Value of fidelity bond cover | 2023-12-31 | $50,000,000 |
| If this is an individual account plan, was there a blackout period | 2023-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Contributions received from participants | 2023-12-31 | $57,990,487 |
| Participant contributions at end of year | 2023-12-31 | $984,877 |
| Participant contributions at beginning of year | 2023-12-31 | $1,005,243 |
| Assets. Other investments not covered elsewhere at end of year | 2023-12-31 | $68,315,242 |
| Assets. Other investments not covered elsewhere at beginning of year | 2023-12-31 | $68,595,727 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-12-31 | $581,315 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-12-31 | $15,611,416 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-12-31 | $20,689,203 |
| Other income not declared elsewhere | 2023-12-31 | $1,194,133 |
| Administrative expenses (other) incurred | 2023-12-31 | $626,231 |
| Liabilities. Value of operating payables at end of year | 2023-12-31 | $5,020,955 |
| Liabilities. Value of operating payables at beginning of year | 2023-12-31 | $4,800,608 |
| Total non interest bearing cash at end of year | 2023-12-31 | $164,375 |
| Total non interest bearing cash at beginning of year | 2023-12-31 | $395,894 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Value of net income/loss | 2023-12-31 | $-16,907,365 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $503,258,918 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $541,772,428 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Investment advisory and management fees | 2023-12-31 | $610,764 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-12-31 | $23,151,685 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-12-31 | $31,594,454 |
| Interest earned on other investments | 2023-12-31 | $118,835 |
| Income. Interest from US Government securities | 2023-12-31 | $941,895 |
| Income. Interest from corporate debt instruments | 2023-12-31 | $1,269,807 |
| Value of interest in master investment trust accounts at end of year | 2023-12-31 | $114,323,256 |
| Value of interest in master investment trust accounts at beginning of year | 2023-12-31 | $145,712,931 |
| Value of interest in common/collective trusts at end of year | 2023-12-31 | $80,257,126 |
| Value of interest in common/collective trusts at beginning of year | 2023-12-31 | $100,342,521 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-12-31 | $17,727,944 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-12-31 | $25,188,939 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-12-31 | $25,188,939 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-12-31 | $1,000,489 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $10,346,794 |
| Asset value of US Government securities at end of year | 2023-12-31 | $28,321,468 |
| Asset value of US Government securities at beginning of year | 2023-12-31 | $25,408,432 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-12-31 | $531,291 |
| Net investment gain or loss from common/collective trusts | 2023-12-31 | $7,584,684 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Contributions received in cash from employer | 2023-12-31 | $180,967,829 |
| Employer contributions (assets) at end of year | 2023-12-31 | $4,978,071 |
| Employer contributions (assets) at beginning of year | 2023-12-31 | $4,157,812 |
| Income. Dividends from preferred stock | 2023-12-31 | $2,524 |
| Income. Dividends from common stock | 2023-12-31 | $2,131,193 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-12-31 | $270,522,025 |
| Asset. Corporate debt instrument preferred debt at end of year | 2023-12-31 | $2,755,121 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2023-12-31 | $2,631,985 |
| Asset. Corporate debt instrument debt (other) at end of year | 2023-12-31 | $69,916,206 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2023-12-31 | $49,510,986 |
| Contract administrator fees | 2023-12-31 | $13,138,835 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2023-12-31 | $102,261,566 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2023-12-31 | $77,504,012 |
| Liabilities. Value of benefit claims payable at end of year | 2023-12-31 | $50,507,146 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-12-31 | $40,880,247 |
| Did the plan have assets held for investment | 2023-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-12-31 | No |
| Aggregate proceeds on sale of assets | 2023-12-31 | $78,399,975 |
| Aggregate carrying amount (costs) on sale of assets | 2023-12-31 | $79,418,854 |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | MITCHELL & TITUS, LLP |
| Accountancy firm EIN | 2023-12-31 | 132781641 |
| 2022 : CONSTELLATION HEALTH CARE PROGRAM 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-17,736,504 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-17,736,504 |
| Total transfer of assets to this plan | 2022-12-31 | $659,159,755 |
| Total transfer of assets from this plan | 2022-12-31 | $15,143,274 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $45,680,855 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
| Total income from all sources (including contributions) | 2022-12-31 | $155,543,608 |
| Total loss/gain on sale of assets | 2022-12-31 | $1,233,594 |
| Total of all expenses incurred | 2022-12-31 | $262,024,502 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $248,012,797 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $198,957,463 |
| Value of total assets at end of year | 2022-12-31 | $583,216,442 |
| Value of total assets at beginning of year | 2022-12-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $14,011,705 |
| Total interest from all sources | 2022-12-31 | $1,575,184 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $2,480,989 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $1,076,308 |
| Assets. Real estate other than employer real property at end of year | 2022-12-31 | $34,667,364 |
| Administrative expenses professional fees incurred | 2022-12-31 | $417,664 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2022-12-31 | $47,780 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $50,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $46,435,010 |
| Participant contributions at end of year | 2022-12-31 | $1,005,243 |
| Assets. Other investments not covered elsewhere at end of year | 2022-12-31 | $68,595,727 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-12-31 | $761,059 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $16,452,362 |
| Other income not declared elsewhere | 2022-12-31 | $253,080 |
| Administrative expenses (other) incurred | 2022-12-31 | $224,095 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $4,800,608 |
| Total non interest bearing cash at end of year | 2022-12-31 | $395,894 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-106,480,894 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $537,535,587 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $0 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $1,088,811 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $31,594,454 |
| Interest earned on other investments | 2022-12-31 | $84,037 |
| Income. Interest from US Government securities | 2022-12-31 | $492,873 |
| Income. Interest from corporate debt instruments | 2022-12-31 | $531,150 |
| Value of interest in master investment trust accounts at end of year | 2022-12-31 | $145,712,931 |
| Value of interest in common/collective trusts at end of year | 2022-12-31 | $100,342,521 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $25,188,939 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $467,124 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $8,078,312 |
| Asset value of US Government securities at end of year | 2022-12-31 | $25,408,432 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-2,636,259 |
| Net investment gain or loss from common/collective trusts | 2022-12-31 | $-7,137,948 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $152,522,453 |
| Employer contributions (assets) at end of year | 2022-12-31 | $4,157,812 |
| Income. Dividends from preferred stock | 2022-12-31 | $1,929 |
| Income. Dividends from common stock | 2022-12-31 | $1,402,752 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $239,173,426 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $2,631,985 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $49,510,986 |
| Contract administrator fees | 2022-12-31 | $12,281,135 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-12-31 | $77,504,012 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $40,880,247 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | Yes |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $29,538,522 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $28,304,928 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | MITCHELL & TITUS, LLP |
| Accountancy firm EIN | 2022-12-31 | 132781641 |
| HUMANA BENEFIT PLAN OF ILLINOIS, INC. (National Association of Insurance Commissioners NAIC id number: 60052 ) |
| Policy contract number | 325131 |
| Policy instance | 6 |
| Insurance contract or identification number | 325131 | | Number of Individuals Covered | 540 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,845,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325129 |
| Policy instance | 5 |
| Insurance contract or identification number | 325129 | | Number of Individuals Covered | 1932 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,689,471 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325125 |
| Policy instance | 4 |
| Insurance contract or identification number | 325125 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $34,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325119 |
| Policy instance | 3 |
| Insurance contract or identification number | 325119 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,553 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3344479 |
| Policy instance | 2 |
| Insurance contract or identification number | 3344479 | | Number of Individuals Covered | 1087 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | PREPAID DENTAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $306,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 286010 |
| Policy instance | 1 |
| Insurance contract or identification number | 286010 | | Number of Individuals Covered | 41202 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $125,000 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA BENEFIT PLAN OF ILLINOIS, INC. (National Association of Insurance Commissioners NAIC id number: 60052 ) |
| Policy contract number | 325131 |
| Policy instance | 6 |
| Insurance contract or identification number | 325131 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,101,150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325129 |
| Policy instance | 5 |
| Insurance contract or identification number | 325129 | | Number of Individuals Covered | 1785 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $4,031,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325125 |
| Policy instance | 4 |
| Insurance contract or identification number | 325125 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $95,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 325119 |
| Policy instance | 3 |
| Insurance contract or identification number | 325119 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3344479 |
| Policy instance | 2 |
| Insurance contract or identification number | 3344479 | | Number of Individuals Covered | 1108 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | PREPAID DENTAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $221,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | D00008 |
| Policy instance | 1 |
| Insurance contract or identification number | D00008 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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