POOL & ELECTRICAL PRODUCTS INC. has sponsored the creation of one or more 401k plans.
Additional information about POOL & ELECTRICAL PRODUCTS INC.
Submission information for form 5500 for 401k plan POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN
401k plan membership statisitcs for POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN
Measure | Date | Value |
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2020: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-11-01 | 246 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 0 |
Number of retired or separated participants receiving benefits | 2020-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-11-01 | 0 |
Total of all active and inactive participants | 2020-11-01 | 0 |
2019: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-11-01 | 184 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 246 |
Number of retired or separated participants receiving benefits | 2019-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-11-01 | 0 |
Total of all active and inactive participants | 2019-11-01 | 246 |
2018: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-11-01 | 204 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 183 |
Number of retired or separated participants receiving benefits | 2018-11-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2018-11-01 | 0 |
Total of all active and inactive participants | 2018-11-01 | 184 |
2017: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-11-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 203 |
Number of retired or separated participants receiving benefits | 2017-11-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 0 |
Total of all active and inactive participants | 2017-11-01 | 204 |
2016: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-11-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 199 |
Number of retired or separated participants receiving benefits | 2016-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 0 |
Total of all active and inactive participants | 2016-11-01 | 199 |
2015: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-11-01 | 196 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 193 |
Number of retired or separated participants receiving benefits | 2015-11-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 0 |
Total of all active and inactive participants | 2015-11-01 | 195 |
2014: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-11-01 | 172 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 194 |
Number of retired or separated participants receiving benefits | 2014-11-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2014-11-01 | 0 |
Total of all active and inactive participants | 2014-11-01 | 196 |
2013: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-11-01 | 169 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 170 |
Number of retired or separated participants receiving benefits | 2013-11-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2013-11-01 | 0 |
Total of all active and inactive participants | 2013-11-01 | 172 |
2012: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-11-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 168 |
Number of retired or separated participants receiving benefits | 2012-11-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2012-11-01 | 0 |
Total of all active and inactive participants | 2012-11-01 | 169 |
2011: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-11-01 | 108 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 161 |
Number of retired or separated participants receiving benefits | 2011-11-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2011-11-01 | 0 |
Total of all active and inactive participants | 2011-11-01 | 166 |
2009: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-11-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 135 |
Number of retired or separated participants receiving benefits | 2009-11-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2009-11-01 | 0 |
Total of all active and inactive participants | 2009-11-01 | 136 |
2020: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2020 form 5500 responses |
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2020-11-01 | Type of plan entity | Single employer plan |
2020-11-01 | Submission has been amended | No |
2020-11-01 | This submission is the final filing | Yes |
2020-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-11-01 | Plan is a collectively bargained plan | No |
2020-11-01 | Plan funding arrangement – Insurance | Yes |
2020-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-11-01 | Plan benefit arrangement – Insurance | Yes |
2020-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2019 form 5500 responses |
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2019-11-01 | Type of plan entity | Single employer plan |
2019-11-01 | Submission has been amended | No |
2019-11-01 | This submission is the final filing | No |
2019-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-11-01 | Plan is a collectively bargained plan | No |
2019-11-01 | Plan funding arrangement – Insurance | Yes |
2019-11-01 | Plan benefit arrangement – Insurance | Yes |
2018: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2018 form 5500 responses |
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2018-11-01 | Type of plan entity | Single employer plan |
2018-11-01 | Submission has been amended | No |
2018-11-01 | This submission is the final filing | No |
2018-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-11-01 | Plan is a collectively bargained plan | No |
2018-11-01 | Plan funding arrangement – Insurance | Yes |
2018-11-01 | Plan benefit arrangement – Insurance | Yes |
2017: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2017 form 5500 responses |
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2017-11-01 | Type of plan entity | Single employer plan |
2017-11-01 | Submission has been amended | No |
2017-11-01 | This submission is the final filing | No |
2017-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-11-01 | Plan is a collectively bargained plan | No |
2017-11-01 | Plan funding arrangement – Insurance | Yes |
2017-11-01 | Plan benefit arrangement – Insurance | Yes |
2016: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2016 form 5500 responses |
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2016-11-01 | Type of plan entity | Single employer plan |
2016-11-01 | Submission has been amended | No |
2016-11-01 | This submission is the final filing | No |
2016-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-11-01 | Plan is a collectively bargained plan | No |
2016-11-01 | Plan funding arrangement – Insurance | Yes |
2016-11-01 | Plan benefit arrangement – Insurance | Yes |
2015: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2015 form 5500 responses |
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2015-11-01 | Type of plan entity | Single employer plan |
2015-11-01 | Submission has been amended | No |
2015-11-01 | This submission is the final filing | No |
2015-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-11-01 | Plan is a collectively bargained plan | No |
2015-11-01 | Plan funding arrangement – Insurance | Yes |
2015-11-01 | Plan benefit arrangement – Insurance | Yes |
2014: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2014 form 5500 responses |
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2014-11-01 | Type of plan entity | Single employer plan |
2014-11-01 | Submission has been amended | No |
2014-11-01 | This submission is the final filing | No |
2014-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-11-01 | Plan is a collectively bargained plan | No |
2014-11-01 | Plan funding arrangement – Insurance | Yes |
2014-11-01 | Plan benefit arrangement – Insurance | Yes |
2013: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2013 form 5500 responses |
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2013-11-01 | Type of plan entity | Single employer plan |
2013-11-01 | Submission has been amended | No |
2013-11-01 | This submission is the final filing | No |
2013-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-11-01 | Plan is a collectively bargained plan | No |
2013-11-01 | Plan funding arrangement – Insurance | Yes |
2013-11-01 | Plan benefit arrangement – Insurance | Yes |
2012: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2012 form 5500 responses |
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2012-11-01 | Type of plan entity | Single employer plan |
2012-11-01 | Submission has been amended | No |
2012-11-01 | This submission is the final filing | No |
2012-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-11-01 | Plan is a collectively bargained plan | No |
2012-11-01 | Plan funding arrangement – Insurance | Yes |
2012-11-01 | Plan benefit arrangement – Insurance | Yes |
2011: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses |
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2011-11-01 | Type of plan entity | Single employer plan |
2011-11-01 | Submission has been amended | No |
2011-11-01 | This submission is the final filing | No |
2011-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-11-01 | Plan is a collectively bargained plan | No |
2011-11-01 | Plan funding arrangement – Insurance | Yes |
2011-11-01 | Plan benefit arrangement – Insurance | Yes |
2009: POOL & ELECTRICAL PRODUCTS, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses |
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2009-11-01 | Type of plan entity | Single employer plan |
2009-11-01 | Submission has been amended | No |
2009-11-01 | This submission is the final filing | No |
2009-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-11-01 | Plan is a collectively bargained plan | No |
2009-11-01 | Plan funding arrangement – Insurance | Yes |
2009-11-01 | Plan benefit arrangement – Insurance | Yes |
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 278856 |
Policy instance | 3 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 78 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $103,993 | Total amount of fees paid to insurance company | USD $5,347 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $533,835 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76,713 | Amount paid for insurance broker fees | 916 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 278856 |
Policy instance | 2 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 318 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,404,906 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00554229 |
Policy instance | 1 |
Insurance contract or identification number | 00554229 | Number of Individuals Covered | 234 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $18,038 | Total amount of fees paid to insurance company | USD $12,867 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $158,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,464 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 12867 | Additional information about fees paid to insurance broker | FEES |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 554229 |
Policy instance | 3 |
Insurance contract or identification number | 554229 | Number of Individuals Covered | 246 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $20,187 | Total amount of fees paid to insurance company | USD $6,821 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $175,926 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,187 | Amount paid for insurance broker fees | 6821 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 278856 |
Policy instance | 2 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 186 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $82,750 | Total amount of fees paid to insurance company | USD $2,217 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,602,411 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82,750 | Amount paid for insurance broker fees | 2217 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 278856 |
Policy instance | 1 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 54 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $24,024 | Total amount of fees paid to insurance company | USD $644 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $567,754 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,024 | Amount paid for insurance broker fees | 644 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 554229 |
Policy instance | 3 |
Insurance contract or identification number | 554229 | Number of Individuals Covered | 224 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $18,265 | Total amount of fees paid to insurance company | USD $1,531 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $156,576 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,265 | Amount paid for insurance broker fees | 1531 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 278856 |
Policy instance | 2 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 168 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $71,451 | Total amount of fees paid to insurance company | USD $987 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,407,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71,451 | Amount paid for insurance broker fees | 987 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 278856 |
Policy instance | 1 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 46 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $25,235 | Total amount of fees paid to insurance company | USD $348 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $497,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,235 | Amount paid for insurance broker fees | 348 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 |
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PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) |
Policy contract number | 15961 |
Policy instance | 6 |
Insurance contract or identification number | 15961 | Number of Individuals Covered | 171 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $6,603 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $67,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 417917 |
Policy instance | 5 |
Insurance contract or identification number | 417917 | Number of Individuals Covered | 63 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $2,835 | Total amount of fees paid to insurance company | USD $483 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $18,901 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 902485 |
Policy instance | 4 |
Insurance contract or identification number | 902485 | Number of Individuals Covered | 28 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $1,393 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $14,008 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 278856 |
Policy instance | 3 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 173 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $62,330 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,383,122 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 278856 |
Policy instance | 2 |
Insurance contract or identification number | 278856 | Number of Individuals Covered | 37 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $14,476 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $321,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9765967 |
Policy instance | 1 |
Insurance contract or identification number | 9765967 | Number of Individuals Covered | 340 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $1,927 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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