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YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameYOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN
Plan identification number 501

YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

YOUNG TRUCK SALES, INC. has sponsored the creation of one or more 401k plans.

Company Name:YOUNG TRUCK SALES, INC.
Employer identification number (EIN):340770683
NAIC Classification:441110
NAIC Description:New Car Dealers

Additional information about YOUNG TRUCK SALES, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1954-10-25
Company Identification Number: 242801
Legal Registered Office Address: 4970 SOUTHWAY ST SW
-
CANTON
United States of America (USA)
447060000

More information about YOUNG TRUCK SALES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01CRAIG YOUNG
5012016-10-01
5012015-10-01

Plan Statistics for YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN

Measure Date Value
2021: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01154
Total number of active participants reported on line 7a of the Form 55002021-10-01287
Total of all active and inactive participants2021-10-01287
Total participants2021-10-01287
2020: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01153
Total number of active participants reported on line 7a of the Form 55002020-10-01154
Total of all active and inactive participants2020-10-01154
Total participants2020-10-01154
2019: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01151
Total number of active participants reported on line 7a of the Form 55002019-10-01153
Total of all active and inactive participants2019-10-01153
Total participants2019-10-01153
2018: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01134
Total number of active participants reported on line 7a of the Form 55002018-10-01151
Total of all active and inactive participants2018-10-01151
Total participants2018-10-01151
2017: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01205
Total number of active participants reported on line 7a of the Form 55002017-10-01134
Total of all active and inactive participants2017-10-01134
Total participants2017-10-01134
2016: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01103
Total number of active participants reported on line 7a of the Form 55002016-10-01205
Total of all active and inactive participants2016-10-01205
Total participants2016-10-01205
2015: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01105
Total number of active participants reported on line 7a of the Form 55002015-10-01103
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01103

Form 5500 Responses for YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN

2021: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: YOUNG TRUCK SALES, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01First time form 5500 has been submittedYes
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1145893
Policy instance 2
Insurance contract or identification number1145893
Number of Individuals Covered287
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $15,522
Total amount of fees paid to insurance companyUSD $3,000
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,605
Commission paid to Insurance BrokerUSD $15,522
Amount paid for insurance broker fees3000
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0070640-01
Policy instance 1
Insurance contract or identification number0070640-01
Number of Individuals Covered127
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $44,210
Total amount of fees paid to insurance companyUSD $21,119
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,694
Commission paid to Insurance BrokerUSD $44,210
Amount paid for insurance broker fees21119
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0070640-01
Policy instance 1
Insurance contract or identification number0070640-01
Number of Individuals Covered124
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $43,158
Total amount of fees paid to insurance companyUSD $4,182
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,746
Commission paid to Insurance BrokerUSD $11,137
Amount paid for insurance broker fees4173
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberYNGT117
Policy instance 2
Insurance contract or identification numberYNGT117
Number of Individuals Covered109
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,685
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,266
Commission paid to Insurance BrokerUSD $4,685
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 3
Insurance contract or identification numberG000B7QV
Number of Individuals Covered154
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $482
Total amount of fees paid to insurance companyUSD $588
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $4,815
Commission paid to Insurance BrokerUSD $40
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees588
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 4
Insurance contract or identification numberG000B7QV
Number of Individuals Covered154
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $3,512
Total amount of fees paid to insurance companyUSD $4,784
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,230
Commission paid to Insurance BrokerUSD $158
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees4784
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 5
Insurance contract or identification numberG000B7QV
Number of Individuals Covered58
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $2,740
Total amount of fees paid to insurance companyUSD $2,261
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $18,268
Commission paid to Insurance BrokerUSD $217
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees2261
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 5
Insurance contract or identification numberG000B7QV
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,016
Total amount of fees paid to insurance companyUSD $1,005
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $20,106
Commission paid to Insurance BrokerUSD $3,016
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees1005
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 4
Insurance contract or identification numberG000B7QV
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,547
Total amount of fees paid to insurance companyUSD $2,047
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,547
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees2047
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 3
Insurance contract or identification numberG000B7QV
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $503
Total amount of fees paid to insurance companyUSD $252
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $5,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $503
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees252
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberYNGT117
Policy instance 2
Insurance contract or identification numberYNGT117
Number of Individuals Covered107
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,933
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,716
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0070640-01
Policy instance 1
Insurance contract or identification number0070640-01
Number of Individuals Covered132
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $45,859
Total amount of fees paid to insurance companyUSD $18,166
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,592
Commission paid to Insurance BrokerUSD $45,859
Amount paid for insurance broker fees18166
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 5
Insurance contract or identification numberG000B7QV
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,071
Total amount of fees paid to insurance companyUSD $468
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $20,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,071
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees468
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 4
Insurance contract or identification numberG000B7QV
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,209
Total amount of fees paid to insurance companyUSD $769
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,209
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees769
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 3
Insurance contract or identification numberG000B7QV
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $463
Total amount of fees paid to insurance companyUSD $104
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $4,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $463
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees104
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberYNGT117
Policy instance 2
Insurance contract or identification numberYNGT117
Number of Individuals Covered105
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $4,083
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,083
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0070640-01
Policy instance 1
Insurance contract or identification number0070640-01
Number of Individuals Covered122
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $42,654
Total amount of fees paid to insurance companyUSD $19,476
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,678
Commission paid to Insurance BrokerUSD $42,654
Amount paid for insurance broker fees19476
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number0070640-01
Policy instance 1
Insurance contract or identification number0070640-01
Number of Individuals Covered109
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $37,932
Total amount of fees paid to insurance companyUSD $14,649
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,645
Commission paid to Insurance BrokerUSD $37,932
Amount paid for insurance broker fees14649
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract numberYNGT117
Policy instance 2
Insurance contract or identification numberYNGT117
Number of Individuals Covered88
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,726
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,726
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 3
Insurance contract or identification numberG000B7QV
Number of Individuals Covered134
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $437
Total amount of fees paid to insurance companyUSD $322
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $4,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $437
Amount paid for insurance broker fees24
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 4
Insurance contract or identification numberG000B7QV
Number of Individuals Covered134
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $3,131
Total amount of fees paid to insurance companyUSD $2,481
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,618
Commission paid to Insurance BrokerUSD $3,131
Amount paid for insurance broker fees185
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B7QV
Policy instance 5
Insurance contract or identification numberG000B7QV
Number of Individuals Covered77
Insurance policy start date2017-10-01
Insurance policy end date2018-10-01
Total amount of commissions paid to insurance brokerUSD $3,149
Total amount of fees paid to insurance companyUSD $1,852
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $20,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,149
Amount paid for insurance broker fees138
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number692441
Policy instance 3
Insurance contract or identification number692441
Number of Individuals Covered194
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $40,307
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $663,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,172
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameCENTER STONE INSURANCE COLUMBUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number534494
Policy instance 2
Insurance contract or identification number534494
Number of Individuals Covered27
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,673
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $8,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,442
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameSIRAK FINANCIAL SERVICES AGENCY INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number678757
Policy instance 1
Insurance contract or identification number678757
Number of Individuals Covered66
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,706
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $37,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,688
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameSIRAK FINANCIAL

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