MIDCON CABLES CO. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MIDCON CABLES CO., INC GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 251 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 288 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 288 |
| 2021: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 251 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 251 |
| 2020: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 200 |
| Total of all active and inactive participants | 2020-01-01 | 200 |
| 2019: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 176 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 7 |
| Total of all active and inactive participants | 2019-01-01 | 183 |
| 2018: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 176 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 176 |
| Total participants | 2018-01-01 | 176 |
| 2017: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 138 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 3 |
| Total of all active and inactive participants | 2017-01-01 | 141 |
| Total participants | 2017-01-01 | 141 |
| 2016: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 115 |
| Total of all active and inactive participants | 2016-01-01 | 115 |
| Total participants | 2016-01-01 | 115 |
| 2015: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 124 |
| Total of all active and inactive participants | 2015-01-01 | 124 |
| Total participants | 2015-01-01 | 124 |
| 2014: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 155 |
| Total of all active and inactive participants | 2014-01-01 | 155 |
| Total participants | 2014-01-01 | 155 |
| 2013: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 156 |
| Total of all active and inactive participants | 2013-01-01 | 156 |
| Total participants | 2013-01-01 | 156 |
| 2012: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 131 |
| Total of all active and inactive participants | 2012-01-01 | 131 |
| Total participants | 2012-01-01 | 131 |
| 2011: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 158 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 153 |
| Total of all active and inactive participants | 2011-01-01 | 153 |
| Total participants | 2011-01-01 | 153 |
| 2010: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 157 |
| Total of all active and inactive participants | 2010-01-01 | 157 |
| Total participants | 2010-01-01 | 157 |
| 2022: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: MIDCON CABLES CO., INC GROUP HEALTH PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: MIDCON CABLES CO., INC GROUP HEALTH PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | 417004414853 |
| Policy instance | 4 |
| Insurance contract or identification number | 417004414853 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $454,641 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
| Policy contract number | EAP |
| Policy instance | 3 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 288 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $9,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05393983 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05393983 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,934 | | Total amount of fees paid to insurance company | USD $2,508 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $140,559 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,167 | | Amount paid for insurance broker fees | 2498 | | Additional information about fees paid to insurance broker | PRODUCER SERVICE FEES NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 1 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 459 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,980 | | Total amount of fees paid to insurance company | USD $561 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $130,569 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,787 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 561 | | Additional information about fees paid to insurance broker | BROKER BONUS |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BPDS |
| Policy instance | 3 |
| Insurance contract or identification number | G000BPDS | | Number of Individuals Covered | 224 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $11,349 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $113,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,349 | | Insurance broker organization code? | 3 |
|
| NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
| Policy contract number | 00000 |
| Policy instance | 2 |
| Insurance contract or identification number | 00000 | | Number of Individuals Covered | 250 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $9,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 1 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,982 | | Total amount of fees paid to insurance company | USD $681 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $122,287 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,982 | | Amount paid for insurance broker fees | 681 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 907599 |
| Policy instance | 3 |
| Insurance contract or identification number | 907599 | | Number of Individuals Covered | 381 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $58,851 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,908,507 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 58851 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 2 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 376 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,760 | | Total amount of fees paid to insurance company | USD $892 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $120,904 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,760 | | Amount paid for insurance broker fees | 892 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BPDS |
| Policy instance | 1 |
| Insurance contract or identification number | G000BPDS | | Number of Individuals Covered | 224 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $11,349 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $113,498 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,349 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 907599 |
| Policy instance | 2 |
| Insurance contract or identification number | 907599 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,498 | | Total amount of fees paid to insurance company | USD $55,387 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | A D & D | | Welfare Benefit Premiums Paid to Carrier | USD $1,677,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,498 | | Amount paid for insurance broker fees | 55387 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT BONUS AMOUNT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 1 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,491 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $108,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,491 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 907599 |
| Policy instance | 2 |
| Insurance contract or identification number | 907599 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,202 | | Total amount of fees paid to insurance company | USD $43,751 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,431,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,202 | | Amount paid for insurance broker fees | 43751 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 1 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,026 | | Total amount of fees paid to insurance company | USD $513 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $100,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,755 | | Amount paid for insurance broker fees | 44 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 907599 |
| Policy instance | 2 |
| Insurance contract or identification number | 907599 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $789 | | Total amount of fees paid to insurance company | USD $41,166 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,340,132 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $789 | | Amount paid for insurance broker fees | 41166 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 | | Insurance broker name | BARKER PHILLIPS JACKSON INC |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 19022000 |
| Policy instance | 1 |
| Insurance contract or identification number | 19022000 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,007 | | Total amount of fees paid to insurance company | USD $420 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,806 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,007 | | Amount paid for insurance broker fees | 420 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL30907 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL30907 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,105 | | Total amount of fees paid to insurance company | USD $40,778 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $110,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,105 | | Amount paid for insurance broker fees | 40778 | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 3 | | Insurance broker name | HEALTHSMART BENEFIT SOLUTIONS INC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 216925 |
| Policy instance | 3 |
| Insurance contract or identification number | 216925 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $6,598 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $77,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,598 | | Insurance broker name | SPECIALTY RISK MANAGEMENT LLC |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,001 | | Total amount of fees paid to insurance company | USD $1,259 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $99,447 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,001 | | Amount paid for insurance broker fees | 1259 | | Additional information about fees paid to insurance broker | OTHER COMMISSION/BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
|
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 291 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $3,109 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,109 | | Additional information about fees paid to insurance broker | DELTA REWARDS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
|
| HCC LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 2020 ) |
| Policy contract number | HCL30907 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL30907 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $7,404 | | Total amount of fees paid to insurance company | USD $39,791 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $127,784 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,404 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 39745 | | Insurance broker name | HEALTHSMART PREFFERED CARE |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 216925 |
| Policy instance | 3 |
| Insurance contract or identification number | 216925 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $6,632 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $84,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,037 | | Insurance broker organization code? | 3 | | Insurance broker name | SPECIALTY RISK MANAGEMENT LLC |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 216925 |
| Policy instance | 3 |
| Insurance contract or identification number | 216925 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $6,107 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $78,222 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,107 | | Insurance broker organization code? | 3 | | Insurance broker name | FINLEY AGENCY INC |
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| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 343 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,286 | | Total amount of fees paid to insurance company | USD $456 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,286 | | Amount paid for insurance broker fees | 456 | | Additional information about fees paid to insurance broker | DELTA REWARDS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 156 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $7,929 | | Total amount of fees paid to insurance company | USD $49,341 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $135,862 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $7,929 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 55 | | Insurance broker name | MEDCOST LLC |
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| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 1 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 301 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $2,868 | | Total amount of fees paid to insurance company | USD $478 | | Dental 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 $2,868 | | Amount paid for insurance broker fees | 478 | | Additional information about fees paid to insurance broker | DELTA REWARDS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 138 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $4,822 | | Total amount of fees paid to insurance company | USD $25,325 | | Welfare Benefit Premiums Paid to Carrier | USD $90,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $4,822 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 714 | | Insurance broker name | HEALTHSMART BENEFIT SOLUTIONS |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 216925 |
| Policy instance | 3 |
| Insurance contract or identification number | 216925 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $4,082 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,981 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,082 | | Insurance broker organization code? | 3 | | Insurance broker name | FINLEY AGENCY INC |
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| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | |
| Policy instance | 4 |
| Number of Individuals Covered | 131 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,873 | | Total amount of fees paid to insurance company | USD $10,584 | | Welfare Benefit Premiums Paid to Carrier | USD $28,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Amount paid for insurance broker fees | 33 | | Additional information about fees paid to insurance broker | BENEFIT FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,873 | | Insurance broker name | BRUCE FINLEY FINLEY AGENCY, INC |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 216925 |
| Policy instance | 4 |
| Insurance contract or identification number | 216925 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $3,314 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | 11/632 |
| Policy instance | 3 |
| Insurance contract or identification number | 11/632 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $6,817 | | Total amount of fees paid to insurance company | USD $35,116 | | Welfare Benefit Premiums Paid to Carrier | USD $129,148 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H44711 |
| Policy instance | 1 |
| Insurance contract or identification number | H44711 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,584 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,787 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 2 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 346 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,029 | | Total amount of fees paid to insurance company | USD $456 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | H44711 |
| Policy instance | 1 |
| Insurance contract or identification number | H44711 | | 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 $8,576 | | Total amount of fees paid to insurance company | USD $527 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,530 | | Commission paid to Insurance Broker | USD $8,576 | | Amount paid for insurance broker fees | 527 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | FINLEY AGENCY INC |
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| 1ST CHOICE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 11/632 |
| Policy instance | 3 |
| Insurance contract or identification number | 11/632 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $6,562 | | Total amount of fees paid to insurance company | USD $38,231 | | Welfare Benefit Premiums Paid to Carrier | USD $124,304 | | Amount paid for insurance broker fees | 36833 | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $6,562 | | Insurance broker name | METAVANTE FIS ACCOUNTING DEPARTMENT |
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| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 1902-1000 |
| Policy instance | 2 |
| Insurance contract or identification number | 1902-1000 | | Number of Individuals Covered | 343 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,874 | | Total amount of fees paid to insurance company | USD $224 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $91,599 | | Commission paid to Insurance Broker | USD $2,874 | | Amount paid for insurance broker fees | 224 | | Additional information about fees paid to insurance broker | DELTA REWARDS | | Insurance broker organization code? | 3 | | Insurance broker name | BEIMDIEK INS. AGENCY |
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