KEYSTONE ADOLESCENT CENTER, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KEYSTONE ADOLESCENT CENTER, INC.
401k plan membership statisitcs for KEYSTONE ADOLESCENT CENTER, INC.
Measure | Date | Value |
---|
2022: KEYSTONE ADOLESCENT CENTER, INC. 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 293 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 266 |
Total of all active and inactive participants | 2022-01-01 | 266 |
2021: KEYSTONE ADOLESCENT CENTER, INC. 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 282 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 293 |
Total of all active and inactive participants | 2021-01-01 | 293 |
2020: KEYSTONE ADOLESCENT CENTER, INC. 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 266 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 282 |
Total of all active and inactive participants | 2020-01-01 | 282 |
2019: KEYSTONE ADOLESCENT CENTER, INC. 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 253 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 266 |
Total of all active and inactive participants | 2019-01-01 | 266 |
2018: KEYSTONE ADOLESCENT CENTER, INC. 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 212 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 253 |
Total of all active and inactive participants | 2018-01-01 | 253 |
2017: KEYSTONE ADOLESCENT CENTER, INC. 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 212 |
Total of all active and inactive participants | 2017-01-01 | 212 |
2016: KEYSTONE ADOLESCENT CENTER, INC. 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 122 |
Total of all active and inactive participants | 2016-01-01 | 122 |
2015: KEYSTONE ADOLESCENT CENTER, INC. 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 166 |
Total of all active and inactive participants | 2015-01-01 | 166 |
2014: KEYSTONE ADOLESCENT CENTER, INC. 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 235 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 168 |
Total of all active and inactive participants | 2014-01-01 | 168 |
2013: KEYSTONE ADOLESCENT CENTER, INC. 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 259 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 235 |
Total of all active and inactive participants | 2013-01-01 | 235 |
2012: KEYSTONE ADOLESCENT CENTER, INC. 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 278 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 259 |
Total of all active and inactive participants | 2012-01-01 | 259 |
2011: KEYSTONE ADOLESCENT CENTER, INC. 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 283 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 278 |
Total of all active and inactive participants | 2011-01-01 | 278 |
2009: KEYSTONE ADOLESCENT CENTER, INC. 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 286 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 296 |
Total of all active and inactive participants | 2009-01-01 | 296 |
2022: KEYSTONE ADOLESCENT CENTER, INC. 2022 form 5500 responses |
---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: KEYSTONE ADOLESCENT CENTER, INC. 2021 form 5500 responses |
---|
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: KEYSTONE ADOLESCENT CENTER, INC. 2020 form 5500 responses |
---|
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: KEYSTONE ADOLESCENT CENTER, INC. 2019 form 5500 responses |
---|
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: KEYSTONE ADOLESCENT CENTER, INC. 2018 form 5500 responses |
---|
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: KEYSTONE ADOLESCENT CENTER, INC. 2017 form 5500 responses |
---|
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: KEYSTONE ADOLESCENT CENTER, INC. 2016 form 5500 responses |
---|
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | Yes |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: KEYSTONE ADOLESCENT CENTER, INC. 2015 form 5500 responses |
---|
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: KEYSTONE ADOLESCENT CENTER, INC. 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: KEYSTONE ADOLESCENT CENTER, INC. 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: KEYSTONE ADOLESCENT CENTER, INC. 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: KEYSTONE ADOLESCENT CENTER, INC. 2011 form 5500 responses |
---|
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: KEYSTONE ADOLESCENT CENTER, INC. 2009 form 5500 responses |
---|
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 105 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $9,418 | Total amount of fees paid to insurance company | USD $3,402 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $75,787 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,418 | Amount paid for insurance broker fees | 3402 | Insurance broker organization code? | 3 |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 284941 |
Policy instance | 1 |
Insurance contract or identification number | 284941 | Number of Individuals Covered | 161 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $18,150 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $635,993 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,150 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 119 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $7,323 | Total amount of fees paid to insurance company | USD $5,149 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $67,123 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,323 | Amount paid for insurance broker fees | 5149 | Insurance broker organization code? | 3 |
|
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 900583301 |
Policy instance | 1 |
Insurance contract or identification number | 900583301 | Number of Individuals Covered | 174 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $24,474 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $636,143 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,474 | Insurance broker organization code? | 3 |
|
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 900583300 |
Policy instance | 1 |
Insurance contract or identification number | 900583300 | Number of Individuals Covered | 171 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $24,418 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $639,598 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,418 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 111 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $6,920 | Total amount of fees paid to insurance company | USD $3,806 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $66,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,920 | Amount paid for insurance broker fees | 3806 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 115 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $4,247 | Total amount of fees paid to insurance company | USD $2,845 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $39,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,247 | Amount paid for insurance broker fees | 2845 | Insurance broker organization code? | 3 |
|
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 900583300 |
Policy instance | 1 |
Insurance contract or identification number | 900583300 | Number of Individuals Covered | 151 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $21,733 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $520,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,733 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 100 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $4,732 | Total amount of fees paid to insurance company | USD $3,293 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $44,699 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,732 | Amount paid for insurance broker fees | 3293 | Insurance broker organization code? | 3 |
|
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 ) |
Policy contract number | 900583300 |
Policy instance | 1 |
Insurance contract or identification number | 900583300 | Number of Individuals Covered | 153 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $19,435 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $528,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,435 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 122 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $5,151 | Total amount of fees paid to insurance company | USD $2,700 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,853 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,151 | Amount paid for insurance broker fees | 2700 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 696922 |
Policy instance | 1 |
Insurance contract or identification number | 696922 | Number of Individuals Covered | 90 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $13,984 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $243,934 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,984 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 90212622 |
Policy instance | 1 |
Insurance contract or identification number | 90212622 | Number of Individuals Covered | 53 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $15,144 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $352,404 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,144 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 113 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $4,927 | Total amount of fees paid to insurance company | USD $2,652 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,218 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,927 | Amount paid for insurance broker fees | 2652 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 90212622 |
Policy instance | 1 |
Insurance contract or identification number | 90212622 | Number of Individuals Covered | 52 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $18,704 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $361,305 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,704 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00369051 |
Policy instance | 2 |
Insurance contract or identification number | 00369051 | Number of Individuals Covered | 116 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $5,311 | Total amount of fees paid to insurance company | USD $3,900 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,892 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,311 | Amount paid for insurance broker fees | 3900 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 5925850000 |
Policy instance | 1 |
Insurance contract or identification number | 5925850000 | Number of Individuals Covered | 235 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $32,093 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $802,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,093 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 2 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 259 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $21,797 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $756,661 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,797 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 1 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 259 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,254 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $147,657 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,254 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 1 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 278 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,644 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $154,804 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 2 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 278 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $24,036 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $793,284 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 1 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 283 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,229 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $207,685 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,229 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1251500-1251571 |
Policy instance | 2 |
Insurance contract or identification number | 1251500-1251571 | Number of Individuals Covered | 283 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $21,196 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $706,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,196 | Insurance broker organization code? | 3 | Insurance broker name | DAVEVIC BENEFIT CONSULTANTS |
|