MIDDLETOWN PARK REHABILIATION AND HEALTH CARE CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PARK MANOR ACQUISITION II, LLC
| Measure | Date | Value |
|---|
| 2022: PARK MANOR ACQUISITION II, LLC 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 29 |
| Total of all active and inactive participants | 2022-01-01 | 29 |
| Total participants | 2022-01-01 | 29 |
| 2021: PARK MANOR ACQUISITION II, LLC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 40 |
| Total of all active and inactive participants | 2021-01-01 | 40 |
| Total participants | 2021-01-01 | 40 |
| 2020: PARK MANOR ACQUISITION II, LLC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 39 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 40 |
| Total of all active and inactive participants | 2020-01-01 | 40 |
| Total participants | 2020-01-01 | 40 |
| 2019: PARK MANOR ACQUISITION II, LLC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 39 |
| Total of all active and inactive participants | 2019-01-01 | 39 |
| Total participants | 2019-01-01 | 39 |
| 2018: PARK MANOR ACQUISITION II, LLC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 185 |
| Total of all active and inactive participants | 2018-01-01 | 185 |
| Total participants | 2018-01-01 | 185 |
| 2017: PARK MANOR ACQUISITION II, LLC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 209 |
| Total of all active and inactive participants | 2017-01-01 | 209 |
| Total participants | 2017-01-01 | 209 |
| 2016: PARK MANOR ACQUISITION II, LLC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 221 |
| Total of all active and inactive participants | 2016-01-01 | 221 |
| Total participants | 2016-01-01 | 221 |
| 2015: PARK MANOR ACQUISITION II, LLC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 207 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 199 |
| Total of all active and inactive participants | 2015-01-01 | 199 |
| Total participants | 2015-01-01 | 199 |
| 2014: PARK MANOR ACQUISITION II, LLC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 207 |
| Total of all active and inactive participants | 2014-01-01 | 207 |
| Total participants | 2014-01-01 | 207 |
| 2013: PARK MANOR ACQUISITION II, LLC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 160 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 58 |
| Total of all active and inactive participants | 2013-01-01 | 58 |
| Total participants | 2013-01-01 | 58 |
| 2012: PARK MANOR ACQUISITION II, LLC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 160 |
| Total of all active and inactive participants | 2012-01-01 | 160 |
| Total participants | 2012-01-01 | 160 |
| 2011: PARK MANOR ACQUISITION II, LLC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 166 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 163 |
| Total of all active and inactive participants | 2011-01-01 | 163 |
| Total participants | 2011-01-01 | 163 |
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 2 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $34 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,249 | | Commission paid to Insurance Broker | USD $34 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $78 | | 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 $777 | | Commission paid to Insurance Broker | USD $78 |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | NJ292 |
| Policy instance | 1 |
| Insurance contract or identification number | NJ292 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,580 | | Total amount of fees paid to insurance company | USD $130 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $2,976 | | Amount paid for insurance broker fees | 26 |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | NJ292 |
| Policy instance | 1 |
| Insurance contract or identification number | NJ292 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $8,022 | | Total amount of fees paid to insurance company | USD $155 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $3,802 | | Amount paid for insurance broker fees | 155 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $87 | | 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 $907 | | Commission paid to Insurance Broker | USD $87 |
|
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $54 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,372 | | Commission paid to Insurance Broker | USD $54 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $154 | | 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 $1,514 | | Commission paid to Insurance Broker | USD $154 |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | NJ292 |
| Policy instance | 1 |
| Insurance contract or identification number | NJ292 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,494 | | Total amount of fees paid to insurance company | USD $241 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $3,169 | | Amount paid for insurance broker fees | 39 |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | NJ292 |
| Policy instance | 1 |
| Insurance contract or identification number | NJ292 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $5,781 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $2,195 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $173 | | 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 $1,675 | | Commission paid to Insurance Broker | USD $173 |
|
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | 64865-5 |
| Policy instance | 3 |
| Insurance contract or identification number | 64865-5 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $73 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,831 | | Commission paid to Insurance Broker | USD $73 |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 41 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $7,064 | | Total amount of fees paid to insurance company | USD $173 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $2,570 | | Amount paid for insurance broker fees | 25 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $144 | | 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 $1,559 | | Commission paid to Insurance Broker | USD $144 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 3 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,756 | | Total amount of fees paid to insurance company | USD $3,937 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $68,680 | | Commission paid to Insurance Broker | USD $5,756 | | Amount paid for insurance broker fees | 3937 |
|
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | 64865-5 |
| Policy instance | 4 |
| Insurance contract or identification number | 64865-5 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $92 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,814 | | Commission paid to Insurance Broker | USD $92 |
|
| RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 ) |
| Policy contract number | 64865-5 |
| Policy instance | 4 |
| Insurance contract or identification number | 64865-5 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $90 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,074 | | Commission paid to Insurance Broker | USD $90 | | Insurance broker name | ROBERT G RELPH AGENCY |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 3 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 209 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $14,135 | | Total amount of fees paid to insurance company | USD $3,745 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $121,322 | | Commission paid to Insurance Broker | USD $14,135 | | Amount paid for insurance broker fees | 3745 | | Insurance broker name | PROFESSIONAL GROUP PLANS |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 13-1898173 |
| Policy instance | 2 |
| Insurance contract or identification number | 13-1898173 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $194 | | 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 $1,963 | | Commission paid to Insurance Broker | USD $194 | | Insurance broker name | ROBERT G RELPH AGENCY |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 45 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $8,652 | | Total amount of fees paid to insurance company | USD $634 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $3,242 | | Amount paid for insurance broker fees | 135 | | Insurance broker name | LAURIE SMITH |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 58-0663085 |
| Policy instance | 1 |
| Insurance contract or identification number | 58-0663085 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $8,151 | | Total amount of fees paid to insurance company | USD $95 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,836 | | Commission paid to Insurance Broker | USD $2,468 | | Amount paid for insurance broker fees | 56 | | Insurance broker name | GRACE IENUSO |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 8 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $366 | | 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 $3,370 | | Commission paid to Insurance Broker | USD $366 | | Insurance broker name | ROBERT G RELPH AGENCY |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 3 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,842 | | Total amount of fees paid to insurance company | USD $3,667 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $98,297 | | Commission paid to Insurance Broker | USD $9,842 | | Amount paid for insurance broker fees | 3667 | | Insurance broker name | PROFESSIONAL GROUP PLANS |
|
| AMERICAN FAMILY LIFE INSURANCE COMPANY OF COLUMBUS (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 58-0663085 |
| Policy instance | 1 |
| Insurance contract or identification number | 58-0663085 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $5,300 | | Total amount of fees paid to insurance company | USD $398 | | Commission paid to Insurance Broker | USD $1,868 | | Amount paid for insurance broker fees | 124 | | Insurance broker name | LARRY JAY BLUM |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 9 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $433 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $433 | | Insurance broker name | ROBERT G RELPH AGENCY |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 3 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $10,311 | | Total amount of fees paid to insurance company | USD $3,648 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Commission paid to Insurance Broker | USD $10,311 | | Amount paid for insurance broker fees | 3648 | | Insurance broker name | PROFESSIONAL GROUP PLANS |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 211834 |
| Policy instance | 1 |
| Insurance contract or identification number | 211834 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $29,569 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $605,737 | | Commission paid to Insurance Broker | USD $6,360 | | Insurance broker name | ZEV WYLER |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 2 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $8,105 | | Total amount of fees paid to insurance company | USD $2,832 | | 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 $76,527 | | Commission paid to Insurance Broker | USD $8,105 | | Amount paid for insurance broker fees | 2832 | | Insurance broker name | PROFESSIONAL GROUP PLANS |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 2 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $6,594 | | Total amount of fees paid to insurance company | USD $1,600 | | 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 $5,260 |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 211834 |
| Policy instance | 1 |
| Insurance contract or identification number | 211834 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $30,876 | | Health Insurance Welfare Benefit | Yes |
|
| HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 ) |
| Policy contract number | 7206022 000 |
| Policy instance | 4 |
| Insurance contract or identification number | 7206022 000 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $9,386 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $260,373 |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 211834 |
| Policy instance | 1 |
| Insurance contract or identification number | 211834 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Total amount of commissions paid to insurance broker | USD $20,668 | | Total amount of fees paid to insurance company | USD $0 |
|
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 211834 |
| Policy instance | 2 |
| Insurance contract or identification number | 211834 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $20,278 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $465,521 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00333653 |
| Policy instance | 3 |
| Insurance contract or identification number | 00333653 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $5,306 | | Total amount of fees paid to insurance company | USD $4,076 | | 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 $54,346 |
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