DONNELLY-BOLAND AND ASSOCIATES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS
401k plan membership statisitcs for DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS
| Measure | Date | Value |
|---|
| 2022 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-06-30 | $-290,756 |
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $-290,756 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $1,443,693 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $1,429,508 |
| Total income from all sources (including contributions) | 2022-06-30 | $3,707,044 |
| Total of all expenses incurred | 2022-06-30 | $3,839,293 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $3,803,723 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $3,945,906 |
| Value of total assets at end of year | 2022-06-30 | $3,443,458 |
| Value of total assets at beginning of year | 2022-06-30 | $3,561,522 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $35,570 |
| Total interest from all sources | 2022-06-30 | $2,712 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $55,621 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-06-30 | $55,621 |
| Administrative expenses professional fees incurred | 2022-06-30 | $35,570 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Contributions received from participants | 2022-06-30 | $747,896 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-06-30 | $9,428 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $8,930 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $13,788 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-06-30 | $1,248 |
| Total non interest bearing cash at end of year | 2022-06-30 | $10,000 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $7,896 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-132,249 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $1,999,765 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $2,132,014 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $3,394,374 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $3,514,260 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $2,712 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $2,498,749 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $-6,439 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $3,198,010 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-06-30 | $1,295,546 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-06-30 | $30,154 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-06-30 | $25,578 |
| Liabilities. Value of benefit claims payable at end of year | 2022-06-30 | $1,443,693 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-06-30 | $1,428,260 |
| Did the plan have assets held for investment | 2022-06-30 | 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 | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2022-06-30 | 390859910 |
| 2021 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-06-30 | $109,832 |
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $109,832 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $1,429,508 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $1,326,071 |
| Total income from all sources (including contributions) | 2021-06-30 | $4,086,509 |
| Total of all expenses incurred | 2021-06-30 | $3,789,936 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $3,755,817 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $3,906,949 |
| Value of total assets at end of year | 2021-06-30 | $3,561,522 |
| Value of total assets at beginning of year | 2021-06-30 | $3,161,512 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $34,119 |
| Total interest from all sources | 2021-06-30 | $69 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $40,339 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-06-30 | $39,564 |
| Administrative expenses professional fees incurred | 2021-06-30 | $34,119 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Contributions received from participants | 2021-06-30 | $735,147 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-06-30 | $19,816 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $13,788 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $11,018 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-06-30 | $1,248 |
| Total non interest bearing cash at end of year | 2021-06-30 | $7,896 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $7,798 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $296,573 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $2,132,014 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $1,835,441 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $3,514,260 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $3,118,537 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $69 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $2,416,274 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $29,320 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $3,171,802 |
| Income. Dividends from common stock | 2021-06-30 | $775 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-06-30 | $1,319,727 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-06-30 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-06-30 | $25,578 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-06-30 | $24,159 |
| Liabilities. Value of benefit claims payable at end of year | 2021-06-30 | $1,428,260 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-06-30 | $1,326,071 |
| Did the plan have assets held for investment | 2021-06-30 | 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 | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2021-06-30 | 390859910 |
| 2020 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $-1,072 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $-1,072 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $1,326,071 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $1,042,350 |
| Total income from all sources (including contributions) | 2020-06-30 | $4,128,718 |
| Total of all expenses incurred | 2020-06-30 | $3,883,952 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $3,851,727 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $4,058,770 |
| Value of total assets at end of year | 2020-06-30 | $3,161,512 |
| Value of total assets at beginning of year | 2020-06-30 | $2,633,025 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $32,225 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $70,015 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-06-30 | $69,267 |
| Administrative expenses professional fees incurred | 2020-06-30 | $32,225 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $773,777 |
| Assets. Other investments not covered elsewhere at end of year | 2020-06-30 | $24,159 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-06-30 | $20,024 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-06-30 | $27,947 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $11,018 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-06-30 | $1,100 |
| Total non interest bearing cash at end of year | 2020-06-30 | $7,798 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $9,983 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $244,766 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $1,835,441 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $1,590,675 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $3,118,537 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $2,603,018 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $2,459,482 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-06-30 | $1,005 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $3,284,993 |
| Income. Dividends from common stock | 2020-06-30 | $748 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $1,364,298 |
| Liabilities. Value of benefit claims payable at end of year | 2020-06-30 | $1,326,071 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-06-30 | $1,041,250 |
| Did the plan have assets held for investment | 2020-06-30 | 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 | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2020-06-30 | 390859910 |
| 2019 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $1,042,350 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $985,065 |
| Total income from all sources (including contributions) | 2019-06-30 | $3,335,316 |
| Total of all expenses incurred | 2019-06-30 | $3,135,075 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $3,100,482 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $3,232,396 |
| Value of total assets at end of year | 2019-06-30 | $2,633,025 |
| Value of total assets at beginning of year | 2019-06-30 | $2,375,499 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $34,593 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $76,688 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-06-30 | $76,688 |
| Administrative expenses professional fees incurred | 2019-06-30 | $34,593 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $71,695 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-06-30 | $57,745 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-06-30 | $1,100 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $200,241 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $1,590,675 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $1,390,434 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $1,499,398 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $973,939 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $1,133,627 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $1,401,560 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $1,401,560 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $2,053,245 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-06-30 | $26,232 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $3,160,701 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $989,492 |
| Liabilities. Value of benefit claims payable at end of year | 2019-06-30 | $1,041,250 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-06-30 | $985,065 |
| Did the plan have assets held for investment | 2019-06-30 | 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 | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2019-06-30 | 390859910 |
| 2018 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $985,065 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $901,587 |
| Total income from all sources (including contributions) | 2018-06-30 | $3,241,299 |
| Total of all expenses incurred | 2018-06-30 | $3,186,594 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $3,144,284 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $3,206,838 |
| Value of total assets at end of year | 2018-06-30 | $2,375,499 |
| Value of total assets at beginning of year | 2018-06-30 | $2,237,316 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $42,310 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $42,200 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-06-30 | $42,200 |
| Administrative expenses professional fees incurred | 2018-06-30 | $42,310 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Contributions received from participants | 2018-06-30 | $48,840 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-06-30 | $86,490 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $54,705 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $1,390,434 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $1,335,729 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $973,939 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-06-30 | $703,580 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $1,401,560 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $1,533,736 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $1,533,736 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $2,067,260 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-06-30 | $-7,739 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $3,157,998 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $990,534 |
| Liabilities. Value of benefit claims payable at end of year | 2018-06-30 | $985,065 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-06-30 | $901,587 |
| Did the plan have assets held for investment | 2018-06-30 | 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 | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2018-06-30 | 390859910 |
| 2017 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $901,587 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $863,366 |
| Total income from all sources (including contributions) | 2017-06-30 | $2,959,046 |
| Total of all expenses incurred | 2017-06-30 | $2,882,816 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $2,852,199 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $2,942,217 |
| Value of total assets at end of year | 2017-06-30 | $2,237,316 |
| Value of total assets at beginning of year | 2017-06-30 | $2,122,865 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $30,617 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-06-30 | $22,109 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-06-30 | $22,109 |
| Administrative expenses professional fees incurred | 2017-06-30 | $30,617 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Contributions received from participants | 2017-06-30 | $612,750 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-06-30 | $78,968 |
| Total non interest bearing cash at beginning of year | 2017-06-30 | $1,533,142 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $76,230 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $1,335,729 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $1,259,499 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-06-30 | $703,580 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-06-30 | $458,287 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $1,533,736 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $1,877,805 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-06-30 | $-5,280 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $2,329,467 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $131,436 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-06-30 | $895,426 |
| Liabilities. Value of benefit claims payable at end of year | 2017-06-30 | $901,587 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-06-30 | $863,366 |
| Did the plan have assets held for investment | 2017-06-30 | 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 | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2017-06-30 | 390859910 |
| 2016 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $863,366 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $785,073 |
| Total income from all sources (including contributions) | 2016-06-30 | $2,873,426 |
| Total of all expenses incurred | 2016-06-30 | $2,791,548 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $2,758,841 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $2,852,695 |
| Value of total assets at end of year | 2016-06-30 | $2,122,865 |
| Value of total assets at beginning of year | 2016-06-30 | $1,962,694 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $32,707 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-06-30 | $13,035 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-06-30 | $13,035 |
| Administrative expenses professional fees incurred | 2016-06-30 | $32,707 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Contributions received from participants | 2016-06-30 | $654,339 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-06-30 | $66,970 |
| Total non interest bearing cash at end of year | 2016-06-30 | $1,533,142 |
| Total non interest bearing cash at beginning of year | 2016-06-30 | $1,512,376 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $81,878 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $1,259,499 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $1,177,621 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-06-30 | $458,287 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-06-30 | $450,318 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $1,895,989 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-06-30 | $7,696 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $2,198,356 |
| Employer contributions (assets) at end of year | 2016-06-30 | $131,436 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-06-30 | $795,882 |
| Liabilities. Value of benefit claims payable at end of year | 2016-06-30 | $863,366 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-06-30 | $785,073 |
| Did the plan have assets held for investment | 2016-06-30 | 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 | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2016-06-30 | 390859910 |
| 2015 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $785,073 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $796,079 |
| Total income from all sources (including contributions) | 2015-06-30 | $2,794,513 |
| Total of all expenses incurred | 2015-06-30 | $2,737,313 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $2,711,120 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $2,793,964 |
| Value of total assets at end of year | 2015-06-30 | $1,962,694 |
| Value of total assets at beginning of year | 2015-06-30 | $1,916,500 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $26,193 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-06-30 | $13,081 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-06-30 | $13,081 |
| Administrative expenses professional fees incurred | 2015-06-30 | $25,788 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Contributions received from participants | 2015-06-30 | $694,778 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-06-30 | $78,817 |
| Administrative expenses (other) incurred | 2015-06-30 | $405 |
| Total non interest bearing cash at end of year | 2015-06-30 | $1,512,376 |
| Total non interest bearing cash at beginning of year | 2015-06-30 | $1,454,738 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $57,200 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $1,177,621 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $1,120,421 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-06-30 | $450,318 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-06-30 | $461,762 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $1,867,495 |
| Net investment gain or loss from common/collective trusts | 2015-06-30 | $-12,532 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $2,099,186 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-06-30 | $764,808 |
| Liabilities. Value of benefit claims payable at end of year | 2015-06-30 | $785,073 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-06-30 | $796,079 |
| Did the plan have assets held for investment | 2015-06-30 | 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 | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2015-06-30 | 390859910 |
| 2014 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $796,079 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $711,978 |
| Total income from all sources (including contributions) | 2014-06-30 | $2,893,490 |
| Total of all expenses incurred | 2014-06-30 | $2,662,467 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $2,634,771 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $2,863,889 |
| Value of total assets at end of year | 2014-06-30 | $1,916,500 |
| Value of total assets at beginning of year | 2014-06-30 | $1,601,376 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $27,696 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-06-30 | $11,869 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-06-30 | $11,869 |
| Administrative expenses professional fees incurred | 2014-06-30 | $27,696 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Contributions received from participants | 2014-06-30 | $660,648 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-06-30 | $73,206 |
| Total non interest bearing cash at end of year | 2014-06-30 | $1,454,738 |
| Total non interest bearing cash at beginning of year | 2014-06-30 | $1,157,658 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $231,023 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $1,120,421 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $889,398 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-06-30 | $461,762 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-06-30 | $443,718 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $1,841,016 |
| Net investment gain or loss from common/collective trusts | 2014-06-30 | $17,732 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $2,203,241 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-06-30 | $720,549 |
| Liabilities. Value of benefit claims payable at end of year | 2014-06-30 | $796,079 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-06-30 | $711,978 |
| Did the plan have assets held for investment | 2014-06-30 | 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 | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | BAKER TILLY |
| Accountancy firm EIN | 2014-06-30 | 390859910 |
| 2013 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $711,977 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $610,199 |
| Total income from all sources (including contributions) | 2013-06-30 | $2,653,323 |
| Total of all expenses incurred | 2013-06-30 | $2,571,228 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $2,549,526 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $2,655,585 |
| Value of total assets at end of year | 2013-06-30 | $1,601,375 |
| Value of total assets at beginning of year | 2013-06-30 | $1,417,502 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $21,702 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-06-30 | $10,330 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-06-30 | $10,330 |
| Administrative expenses professional fees incurred | 2013-06-30 | $21,702 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Contributions received from participants | 2013-06-30 | $624,444 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-06-30 | $28,791 |
| Total non interest bearing cash at end of year | 2013-06-30 | $1,157,657 |
| Total non interest bearing cash at beginning of year | 2013-06-30 | $1,261,013 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $82,095 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $889,398 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $807,303 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-06-30 | $443,718 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-06-30 | $156,489 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $1,806,443 |
| Net investment gain or loss from common/collective trusts | 2013-06-30 | $-12,592 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $2,031,141 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-06-30 | $714,292 |
| Liabilities. Value of benefit claims payable at end of year | 2013-06-30 | $711,977 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-06-30 | $610,199 |
| Did the plan have assets held for investment | 2013-06-30 | 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 | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | PARENTEBEARD LLC |
| Accountancy firm EIN | 2013-06-30 | 232932984 |
| 2012 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $610,199 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $523,131 |
| Total income from all sources (including contributions) | 2012-06-30 | $2,424,268 |
| Total of all expenses incurred | 2012-06-30 | $2,354,394 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $2,326,213 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $2,414,508 |
| Value of total assets at end of year | 2012-06-30 | $1,417,502 |
| Value of total assets at beginning of year | 2012-06-30 | $1,260,560 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $28,181 |
| Total interest from all sources | 2012-06-30 | $630 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-06-30 | $6,395 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-06-30 | $6,395 |
| Administrative expenses professional fees incurred | 2012-06-30 | $28,181 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Contributions received from participants | 2012-06-30 | $598,640 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-06-30 | $47,509 |
| Total non interest bearing cash at end of year | 2012-06-30 | $1,261,013 |
| Total non interest bearing cash at beginning of year | 2012-06-30 | $1,105,582 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $69,874 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $807,303 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $737,429 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-06-30 | $156,489 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-06-30 | $154,978 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $630 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $1,553,811 |
| Net investment gain or loss from common/collective trusts | 2012-06-30 | $2,735 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $1,815,868 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-06-30 | $724,893 |
| Liabilities. Value of benefit claims payable at end of year | 2012-06-30 | $610,199 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-06-30 | $523,131 |
| Did the plan have assets held for investment | 2012-06-30 | 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 | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | PARENTEBEARD LLC |
| Accountancy firm EIN | 2012-06-30 | 232932984 |
| 2011 : DONNELLY-BOLAND AND ASSOCIATES WELFARE BENEFITS 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $523,131 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $435,760 |
| Total income from all sources (including contributions) | 2011-06-30 | $2,148,104 |
| Total of all expenses incurred | 2011-06-30 | $2,099,880 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $2,073,902 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $2,139,074 |
| Value of total assets at end of year | 2011-06-30 | $1,260,560 |
| Value of total assets at beginning of year | 2011-06-30 | $1,124,965 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $25,978 |
| Total interest from all sources | 2011-06-30 | $2,199 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-06-30 | $5,071 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-06-30 | $5,071 |
| Administrative expenses professional fees incurred | 2011-06-30 | $25,978 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Contributions received from participants | 2011-06-30 | $506,833 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-06-30 | $70,192 |
| Total non interest bearing cash at end of year | 2011-06-30 | $1,105,582 |
| Total non interest bearing cash at beginning of year | 2011-06-30 | $968,680 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $48,224 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $737,429 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $689,205 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-06-30 | $154,978 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-06-30 | $153,218 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $2,199 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $1,339,300 |
| Net investment gain or loss from common/collective trusts | 2011-06-30 | $1,760 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $1,632,241 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $3,067 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $664,410 |
| Liabilities. Value of benefit claims payable at end of year | 2011-06-30 | $523,131 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-06-30 | $435,760 |
| Did the plan have assets held for investment | 2011-06-30 | No |
| 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 | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | PARENTEBEARD LLC |
| Accountancy firm EIN | 2011-06-30 | 232932984 |
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079919 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079919 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $43 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $545 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079912 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $21 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 93916 |
| Policy instance | 16 |
| Insurance contract or identification number | 93916 | | Number of Individuals Covered | 396 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $37,755 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $258,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,841 | | Insurance broker organization code? | 3 |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 3038 |
| Policy instance | 15 |
| Insurance contract or identification number | 3038 | | Number of Individuals Covered | 372 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $508 | | Total amount of fees paid to insurance company | USD $0 | | 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 $508 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00907802 |
| Policy instance | 9 |
| Insurance contract or identification number | 00907802 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $3,466 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $232,546 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,466 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079915 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $54 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079805 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079805 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $2,296 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $149,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,296 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079804 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079804 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $660 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $48,671 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $660 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079803 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079803 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $1,907 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $122,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,907 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079920 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079920 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $25 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,774 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079923 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079923 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $64 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $3,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079801 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079801 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $2,623 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $173,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,623 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079800 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079800 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $795 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $48,841 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $795 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $5,437 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $375,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,437 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079316 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $3,884 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $259,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,884 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $3,655 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $253,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,655 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $2,145 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $151,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,145 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $3,111 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $208,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,111 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 1 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $1,073 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $76,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,073 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079800 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079800 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $1,810 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $93,766 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,810 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $7,510 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $376,994 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,510 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079316 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $5,106 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $264,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,106 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $3,915 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $197,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,915 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $2,848 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $141,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,848 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $4,285 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $214,543 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,285 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 1 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $2,619 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $125,366 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,619 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 00907802 |
| Policy instance | 9 |
| Insurance contract or identification number | 00907802 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $5,527 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $275,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,527 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079803 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079803 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $1,712 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $96,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,712 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079801 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079801 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $3,897 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $199,805 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,897 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 93916 |
| Policy instance | 17 |
| Insurance contract or identification number | 93916 | | Number of Individuals Covered | 374 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $29,756 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $260,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,720 | | Insurance broker organization code? | 3 |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 3038 |
| Policy instance | 16 |
| Insurance contract or identification number | 3038 | | Number of Individuals Covered | 399 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $1,242 | | Total amount of fees paid to insurance company | USD $0 | | 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 $1,242 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079919 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079919 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079917 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079917 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079915 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $114 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $6,161 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $114 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079805 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079805 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $2,937 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $160,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,937 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079804 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079804 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $1,303 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $70,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,303 | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $6,391 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,391 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079316 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $2,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,426 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $4,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,064 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $2,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,889 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $4,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,232 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $3,792 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,792 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $3,506 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,506 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 1 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $2,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,020 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079800 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079800 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $1,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,187 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079801 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079801 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $1,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,649 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $2,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,773 |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 3038 |
| Policy instance | 26 |
| Insurance contract or identification number | 3038 | | Number of Individuals Covered | 397 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $548 | | 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 $548 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079802 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079802 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $4,503 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,503 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079920 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079920 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079919 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079919 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079918 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079918 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $28 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079917 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079917 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079913 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079915 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079916 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079916 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079801 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079801 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $628 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $628 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $213 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079913 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079915 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079916 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079916 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079917 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079917 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079918 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079918 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079920 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079920 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079800 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079800 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $227 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $227 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 1 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $3,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,338 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $67 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $6,170 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,170 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $2,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,249 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $3,131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,131 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $4,571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,571 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $3,180 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,180 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $3,403 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,403 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079802 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079802 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $2,653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,653 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2018-04-30 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $63 | | 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 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079919 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079919 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079316 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $1,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,562 |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079905 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079905 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079907 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $5,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079908 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079908 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $22 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079913 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $7 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079915 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079916 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079916 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079917 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079917 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079302 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $3,741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079305 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $321 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079308 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $1,316 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $3,632 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079316 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079908 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079913 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $101 | | Welfare Benefit Premiums Paid to Carrier | USD $4,173 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $101 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079305 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $1,186 | | Welfare Benefit Premiums Paid to Carrier | USD $61,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,186 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079916 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079916 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $6,644 | | Welfare Benefit Premiums Paid to Carrier | USD $321,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,644 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079915 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079915 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079917 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079917 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 301 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $16,412 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $227,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,412 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $9,414 | | Welfare Benefit Premiums Paid to Carrier | USD $233,334 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,707 | | Insurance broker name | LIBERTY INSURANCE SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079905 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079905 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $8,800 | | Welfare Benefit Premiums Paid to Carrier | USD $430,726 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,800 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079308 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $1,713 | | Welfare Benefit Premiums Paid to Carrier | USD $88,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,713 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $2,488 | | Welfare Benefit Premiums Paid to Carrier | USD $114,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,488 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $1,655 | | Welfare Benefit Premiums Paid to Carrier | USD $87,327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,655 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $3,194 | | Welfare Benefit Premiums Paid to Carrier | USD $161,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,194 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079316 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079316 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079315 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079315 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $742 | | Welfare Benefit Premiums Paid to Carrier | USD $48,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $742 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079317 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079317 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $359 | | Welfare Benefit Premiums Paid to Carrier | USD $23,446 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $359 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $10 | | Welfare Benefit Premiums Paid to Carrier | USD $512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079302 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $550 | | Welfare Benefit Premiums Paid to Carrier | USD $29,667 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $550 | | Insurance broker name | LIBERTY INSURANCE SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079306 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079306 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $718 | | Welfare Benefit Premiums Paid to Carrier | USD $29,083 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $718 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079906 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079906 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079303 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079303 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $897 | | Welfare Benefit Premiums Paid to Carrier | USD $40,810 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $897 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $6,791 | | Welfare Benefit Premiums Paid to Carrier | USD $343,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,791 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079305 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $850 | | Welfare Benefit Premiums Paid to Carrier | USD $43,675 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $850 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $9,058 | | Welfare Benefit Premiums Paid to Carrier | USD $452,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,058 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079308 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $1,204 | | Welfare Benefit Premiums Paid to Carrier | USD $64,755 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,204 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $2,296 | | Welfare Benefit Premiums Paid to Carrier | USD $123,741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,296 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $857 | | Welfare Benefit Premiums Paid to Carrier | USD $50,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $857 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079900 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079900 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $5,958 | | Welfare Benefit Premiums Paid to Carrier | USD $288,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,958 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079300 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079300 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $592 | | Welfare Benefit Premiums Paid to Carrier | USD $25,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $592 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079903 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079903 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079905 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079905 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079907 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $3 | | Welfare Benefit Premiums Paid to Carrier | USD $2,213 | | 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 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079908 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079913 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079302 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2015-03-31 | | Welfare Benefit Premiums Paid to Carrier | USD $19,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $3,157 | | Welfare Benefit Premiums Paid to Carrier | USD $169,684 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,157 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 300 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $15,988 | | Total amount of fees paid to insurance company | USD $7,014 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SHORT TERM DISABILITY (ALTERNATELY | | Welfare Benefit Premiums Paid to Carrier | USD $214,769 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,988 | | Amount paid for insurance broker fees | 7014 | | Insurance broker organization code? | 1 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079308 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $881 | | Welfare Benefit Premiums Paid to Carrier | USD $54,341 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $881 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079307 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $7,534 | | Welfare Benefit Premiums Paid to Carrier | USD $487,464 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,534 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079312 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079312 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $803 | | Welfare Benefit Premiums Paid to Carrier | USD $55,203 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $803 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079306 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079306 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $452 | | Welfare Benefit Premiums Paid to Carrier | USD $34,051 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $452 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079305 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $515 | | Welfare Benefit Premiums Paid to Carrier | USD $35,202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $515 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079304 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $5,657 | | Welfare Benefit Premiums Paid to Carrier | USD $365,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,657 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079303 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079303 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $830 | | Welfare Benefit Premiums Paid to Carrier | USD $52,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $830 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079302 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $523 | | Welfare Benefit Premiums Paid to Carrier | USD $34,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $523 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079301 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $5,094 | | Welfare Benefit Premiums Paid to Carrier | USD $332,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,094 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079300 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079300 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $523 | | Welfare Benefit Premiums Paid to Carrier | USD $33,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $523 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079314 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079314 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $1,514 | | Welfare Benefit Premiums Paid to Carrier | USD $98,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,514 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079900 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079900 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079901 |
| Policy instance | 25 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079914 |
| Policy instance | 24 |
| Insurance contract or identification number | 009079914 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079913 |
| Policy instance | 23 |
| Insurance contract or identification number | 009079913 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079912 |
| Policy instance | 22 |
| Insurance contract or identification number | 009079912 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079908 |
| Policy instance | 21 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079907 |
| Policy instance | 20 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $23 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079906 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079906 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079905 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079905 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079904 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $17 | | Welfare Benefit Premiums Paid to Carrier | USD $859 | | 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 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079903 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079903 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079902 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $15,257 | | Total amount of fees paid to insurance company | USD $4,891 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $187,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,257 | | Amount paid for insurance broker fees | 4891 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
| Policy contract number | 009079313 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079313 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $91 | | Welfare Benefit Premiums Paid to Carrier | USD $5,871 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $91 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $14,951 | | Total amount of fees paid to insurance company | USD $6,170 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $185,574 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,951 | | Amount paid for insurance broker fees | 6170 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079901 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $-25 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $-25 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079904 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079904 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $146 | | Welfare Benefit Premiums Paid to Carrier | USD $5,297 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $146 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079908 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079900 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079900 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079902 |
| Policy instance | 15 |
| Insurance contract or identification number | 009079902 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079907 |
| Policy instance | 19 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079905 |
| Policy instance | 17 |
| Insurance contract or identification number | 009079905 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079906 |
| Policy instance | 18 |
| Insurance contract or identification number | 009079906 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $8 | | Welfare Benefit Premiums Paid to Carrier | USD $414 | | 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 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079308 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,360 | | Welfare Benefit Premiums Paid to Carrier | USD $62,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,360 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079306 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079306 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,315 | | Welfare Benefit Premiums Paid to Carrier | USD $61,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,315 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079903 |
| Policy instance | 16 |
| Insurance contract or identification number | 009079903 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $8 | | Welfare Benefit Premiums Paid to Carrier | USD $414 | | 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 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079300 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079300 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,067 | | Welfare Benefit Premiums Paid to Carrier | USD $47,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,067 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079301 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $6,385 | | Welfare Benefit Premiums Paid to Carrier | USD $293,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,385 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079304 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $5,796 | | Welfare Benefit Premiums Paid to Carrier | USD $268,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,796 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079302 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $240 | | Welfare Benefit Premiums Paid to Carrier | USD $11,294 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $240 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079303 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079303 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,258 | | Welfare Benefit Premiums Paid to Carrier | USD $57,578 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,258 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079305 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,224 | | Welfare Benefit Premiums Paid to Carrier | USD $56,536 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,224 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079307 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $9,805 | | Welfare Benefit Premiums Paid to Carrier | USD $452,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,805 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079304 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-01 | | Total amount of commissions paid to insurance broker | USD $5,953 | | Welfare Benefit Premiums Paid to Carrier | USD $297,370 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079300 |
| Policy instance | 2 |
| Insurance contract or identification number | 009079300 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $627 | | Welfare Benefit Premiums Paid to Carrier | USD $33,178 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079305 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,214 | | Welfare Benefit Premiums Paid to Carrier | USD $60,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079306 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079306 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,560 | | Welfare Benefit Premiums Paid to Carrier | USD $78,870 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079303 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079303 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-01 | | Total amount of commissions paid to insurance broker | USD $1,025 | | Welfare Benefit Premiums Paid to Carrier | USD $51,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079308 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,470 | | Welfare Benefit Premiums Paid to Carrier | USD $73,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079307 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $8,200 | | Welfare Benefit Premiums Paid to Carrier | USD $410,968 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 1 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $14,048 | | Total amount of fees paid to insurance company | USD $5,863 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079301 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $4,954 | | Welfare Benefit Premiums Paid to Carrier | USD $248,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079302 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $263 | | Welfare Benefit Premiums Paid to Carrier | USD $13,539 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079908 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $-13 | | Welfare Benefit Premiums Paid to Carrier | USD $-653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079904 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079904 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH NETWORK, INC. (National Association of Insurance Commissioners NAIC id number: 11994 ) |
| Policy contract number | 009079901 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079901 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $89 | | Welfare Benefit Premiums Paid to Carrier | USD $3,229 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079308 |
| Policy instance | 11 |
| Insurance contract or identification number | 009079308 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $1,812 | | Welfare Benefit Premiums Paid to Carrier | USD $90,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,812 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05586921 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05586921 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $575 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $206 | | 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 name | DAN DESTEFANO |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079300 |
| Policy instance | 3 |
| Insurance contract or identification number | 009079300 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $951 | | Welfare Benefit Premiums Paid to Carrier | USD $47,540 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $951 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079301 |
| Policy instance | 4 |
| Insurance contract or identification number | 009079301 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $3,832 | | Welfare Benefit Premiums Paid to Carrier | USD $191,592 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,832 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00457170 |
| Policy instance | 2 |
| Insurance contract or identification number | 00457170 | | Number of Individuals Covered | 282 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $13,215 | | Total amount of fees paid to insurance company | USD $4,743 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,215 | | Amount paid for insurance broker fees | 4743 | | Insurance broker name | LIBERTY FINANCIAL SERVICES INC |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079302 |
| Policy instance | 5 |
| Insurance contract or identification number | 009079302 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $411 | | Welfare Benefit Premiums Paid to Carrier | USD $20,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $411 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079303 |
| Policy instance | 6 |
| Insurance contract or identification number | 009079303 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $1,276 | | Welfare Benefit Premiums Paid to Carrier | USD $63,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,276 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079304 |
| Policy instance | 7 |
| Insurance contract or identification number | 009079304 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $3,448 | | Welfare Benefit Premiums Paid to Carrier | USD $172,398 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,448 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079305 |
| Policy instance | 8 |
| Insurance contract or identification number | 009079305 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $2,037 | | Welfare Benefit Premiums Paid to Carrier | USD $101,868 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,037 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079307 |
| Policy instance | 10 |
| Insurance contract or identification number | 009079307 | | Number of Individuals Covered | 87 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $5,173 | | Welfare Benefit Premiums Paid to Carrier | USD $258,669 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,173 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079907 |
| Policy instance | 12 |
| Insurance contract or identification number | 009079907 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $62 | | Welfare Benefit Premiums Paid to Carrier | USD $3,075 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079908 |
| Policy instance | 13 |
| Insurance contract or identification number | 009079908 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $-8 | | 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 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079901 |
| Policy instance | 14 |
| Insurance contract or identification number | 009079901 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $150 | | Welfare Benefit Premiums Paid to Carrier | USD $7,517 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $150 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
| UPMC HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95216 ) |
| Policy contract number | 009079306 |
| Policy instance | 9 |
| Insurance contract or identification number | 009079306 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $1,428 | | Welfare Benefit Premiums Paid to Carrier | USD $71,414 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,428 | | Insurance broker name | LIBERTY FINANCIAL SERVICES |
|
