ST. BARNABAS HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN
401k plan membership statisitcs for ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN
Measure | Date | Value |
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2022: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 299 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 305 |
Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
Total of all active and inactive participants | 2022-07-01 | 305 |
2021: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 299 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
Total of all active and inactive participants | 2021-07-01 | 299 |
2020: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 327 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 318 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
Total of all active and inactive participants | 2020-07-01 | 318 |
2019: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 345 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 327 |
Number of retired or separated participants receiving benefits | 2019-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
Total of all active and inactive participants | 2019-07-01 | 327 |
2018: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 340 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 345 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 345 |
2017: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 334 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 340 |
Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
Total of all active and inactive participants | 2017-07-01 | 340 |
2016: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 339 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 334 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
Total of all active and inactive participants | 2016-07-01 | 334 |
2015: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 299 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 339 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
Total of all active and inactive participants | 2015-07-01 | 339 |
2014: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 300 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 299 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
Total of all active and inactive participants | 2014-07-01 | 299 |
2013: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 291 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 300 |
Total of all active and inactive participants | 2013-07-01 | 300 |
2012: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 215 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 291 |
Total of all active and inactive participants | 2012-07-01 | 291 |
2011: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 215 |
Total of all active and inactive participants | 2011-07-01 | 215 |
2009: ST. BARNABAS HEALTH SYSTEM, INC. HEALTH AND WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 230 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 217 |
Total of all active and inactive participants | 2009-07-01 | 217 |
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | 0100144351, ETC |
Policy instance | 5 |
Insurance contract or identification number | 0100144351, ETC | Number of Individuals Covered | 26 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $11,128 | Total amount of fees paid to insurance company | USD $1,228 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,081 | Amount paid for insurance broker fees | 5 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | G169641 |
Policy instance | 4 |
Insurance contract or identification number | G169641 | Number of Individuals Covered | 305 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $13,480 | Total amount of fees paid to insurance company | USD $511 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $90,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,975 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 511 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 214 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $779 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $779 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 136-421784 |
Policy instance | 2 |
Insurance contract or identification number | 136-421784 | Number of Individuals Covered | 462 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65,800 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
Policy contract number | T09 |
Policy instance | 1 |
Insurance contract or identification number | T09 | Number of Individuals Covered | 244 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $296,806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
|
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
Policy contract number | T09 |
Policy instance | 1 |
Insurance contract or identification number | T09 | Number of Individuals Covered | 244 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $350,699 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 912738 |
Policy instance | 2 |
Insurance contract or identification number | 912738 | Number of Individuals Covered | 197 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $97,521 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 215 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $781 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $781 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B57F |
Policy instance | 4 |
Insurance contract or identification number | G000B57F | Number of Individuals Covered | 299 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $10,198 | Total amount of fees paid to insurance company | USD $8,237 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $105,962 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,198 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4942 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) |
Policy contract number | 0100144351, ETC |
Policy instance | 5 |
Insurance contract or identification number | 0100144351, ETC | Number of Individuals Covered | 17 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $6,888 | Total amount of fees paid to insurance company | USD $2,636 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,207 | Amount paid for insurance broker fees | 198 | Insurance broker organization code? | 3 |
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BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
Policy contract number | T09 |
Policy instance | 1 |
Insurance contract or identification number | T09 | Number of Individuals Covered | 254 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $322,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 912738 |
Policy instance | 2 |
Insurance contract or identification number | 912738 | Number of Individuals Covered | 203 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,261 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 216 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $834 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $834 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B57F |
Policy instance | 4 |
Insurance contract or identification number | G000B57F | Number of Individuals Covered | 318 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $10,543 | Total amount of fees paid to insurance company | USD $10,813 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,415 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,543 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 7208 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 468 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $170,937 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 912738 |
Policy instance | 2 |
Insurance contract or identification number | 912738 | Number of Individuals Covered | 225 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $95,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 241 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $888 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $888 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B57F |
Policy instance | 4 |
Insurance contract or identification number | G000B57F | Number of Individuals Covered | 327 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $11,084 | Total amount of fees paid to insurance company | USD $9,519 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $116,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,084 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 6346 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 523 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $11,915 | Welfare Benefit Premiums Paid to Carrier | USD $164,111 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,915 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 912738 |
Policy instance | 2 |
Insurance contract or identification number | 912738 | Number of Individuals Covered | 197 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,379 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 218 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $867 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $867 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B57F |
Policy instance | 4 |
Insurance contract or identification number | G000B57F | Number of Individuals Covered | 345 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $9,927 | Total amount of fees paid to insurance company | USD $6,438 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $105,146 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,927 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 6438 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B57F |
Policy instance | 4 |
Insurance contract or identification number | G000B57F | Number of Individuals Covered | 334 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $9,984 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $105,376 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,238 | Insurance broker organization code? | 3 | Insurance broker name | COURY HEALTH SERVICES LLC |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 204 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $781 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $396 | Insurance broker organization code? | 3 | Insurance broker name | SIMPSON & MCCARDY BENEFITS |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 350 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,210 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 518 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $11,693 | Welfare Benefit Premiums Paid to Carrier | USD $163,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,693 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10170456-8 |
Policy instance | 4 |
Insurance contract or identification number | 10170456-8 | Number of Individuals Covered | 339 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $8,236 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $94,806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,236 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
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UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 502 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $7,485 | Welfare Benefit Premiums Paid to Carrier | USD $110,962 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,485 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 328 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,194 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 182 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $685 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $685 | Insurance broker organization code? | 3 | Insurance broker name | FOUR M CONSULTING INC. |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 285 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 139 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $553 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $553 | Insurance broker organization code? | 3 | Insurance broker name | FOUR M CONSULTING INC. |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10170456-8 |
Policy instance | 4 |
Insurance contract or identification number | 10170456-8 | Number of Individuals Covered | 299 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $6,919 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $76,795 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,919 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
|
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 416 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $6,659 | Welfare Benefit Premiums Paid to Carrier | USD $89,080 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,659 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 3 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 139 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $593 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $593 | Insurance broker organization code? | 3 | Insurance broker name | FOUR M CONSULTING INC. |
|
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 448 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $93,818 | 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 | WELLS FARGO INS PA |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 205 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10170456-8 |
Policy instance | 4 |
Insurance contract or identification number | 10170456-8 | Number of Individuals Covered | 300 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $7,923 | Total amount of fees paid to insurance company | USD $4,690 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,168 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,923 | Amount paid for insurance broker fees | 4690 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10170456-8 |
Policy instance | 5 |
Insurance contract or identification number | 10170456-8 | Number of Individuals Covered | 291 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $4,218 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,052 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,218 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SVCS USA INC. |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 1728 |
Policy instance | 4 |
Insurance contract or identification number | 1728 | Number of Individuals Covered | 135 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $580 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $580 | Insurance broker organization code? | 3 | Insurance broker name | FOUR M CONSULTING INC. |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 161606,148240,1 |
Policy instance | 3 |
Insurance contract or identification number | 161606,148240,1 | Number of Individuals Covered | 292 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,140 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,773 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,140 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SERVICES |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 144 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 410 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $98,352 | 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 | WELLS FARGO INS PA |
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UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 ) |
Policy contract number | 016101800 |
Policy instance | 1 |
Insurance contract or identification number | 016101800 | Number of Individuals Covered | 230 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Welfare Benefit Premiums Paid to Carrier | USD $85,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 2 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 131 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,723 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 1616061482401 |
Policy instance | 3 |
Insurance contract or identification number | 1616061482401 | Number of Individuals Covered | 269 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $7,455 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,244 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 16101300-902 |
Policy instance | 1 |
Insurance contract or identification number | 16101300-902 | Number of Individuals Covered | 199 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $4,059 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 16101300-902 |
Policy instance | 2 |
Insurance contract or identification number | 16101300-902 | Number of Individuals Covered | 199 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $4,368 | Welfare Benefit Premiums Paid to Carrier | USD $82,602 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 9163 |
Policy instance | 3 |
Insurance contract or identification number | 9163 | Number of Individuals Covered | 149 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10112502 |
Policy instance | 4 |
Insurance contract or identification number | 10112502 | Number of Individuals Covered | 267 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,028 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 1616061482401 |
Policy instance | 5 |
Insurance contract or identification number | 1616061482401 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $3,597 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,185 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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