P T SERVICES REHABILITATION INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PT SERVICES INC EMPLOYEE BENEFIT TRUST
| Measure | Date | Value |
|---|
| 2023: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-04-01 | 198 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-04-01 | 172 |
| Number of retired or separated participants receiving benefits | 2023-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-04-01 | 0 |
| Total of all active and inactive participants | 2023-04-01 | 172 |
| Number of employers contributing to the scheme | 2023-04-01 | 0 |
| 2022: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 198 |
| Number of retired or separated participants receiving benefits | 2022-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-04-01 | 0 |
| Total of all active and inactive participants | 2022-04-01 | 198 |
| Number of employers contributing to the scheme | 2022-04-01 | 0 |
| 2020: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 183 |
| Number of retired or separated participants receiving benefits | 2020-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-04-01 | 0 |
| Total of all active and inactive participants | 2020-04-01 | 183 |
| Number of employers contributing to the scheme | 2020-04-01 | 0 |
| 2019: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 128 |
| Number of retired or separated participants receiving benefits | 2019-04-01 | 2 |
| Total of all active and inactive participants | 2019-04-01 | 130 |
| Total participants | 2019-04-01 | 130 |
| 2018: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 129 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 2 |
| Total of all active and inactive participants | 2018-04-01 | 131 |
| Total participants | 2018-04-01 | 131 |
| Number of participants with account balances | 2018-04-01 | 131 |
| 2017: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 133 |
| Total of all active and inactive participants | 2017-04-01 | 133 |
| Total participants | 2017-04-01 | 133 |
| 2016: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 133 |
| Total of all active and inactive participants | 2016-04-01 | 133 |
| Total participants | 2016-04-01 | 133 |
| 2015: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 138 |
| Total of all active and inactive participants | 2015-04-01 | 138 |
| Total participants | 2015-04-01 | 138 |
| 2014: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 132 |
| Total of all active and inactive participants | 2014-04-01 | 132 |
| Total participants | 2014-04-01 | 132 |
| 2013: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 135 |
| Total of all active and inactive participants | 2013-04-01 | 135 |
| Total participants | 2013-04-01 | 135 |
| 2012: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 140 |
| Total of all active and inactive participants | 2012-04-01 | 140 |
| Total participants | 2012-04-01 | 140 |
| Number of participants with account balances | 2012-04-01 | 140 |
| 2011: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 0 |
| Number of retired or separated participants receiving benefits | 2011-04-01 | 0 |
| Total of all active and inactive participants | 2011-04-01 | 0 |
| Total participants | 2011-04-01 | 0 |
| 2010: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 143 |
| Number of retired or separated participants receiving benefits | 2010-04-01 | 2 |
| Total of all active and inactive participants | 2010-04-01 | 145 |
| Total participants | 2010-04-01 | 145 |
| 2009: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 141 |
| Number of retired or separated participants receiving benefits | 2009-04-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2009-04-01 | 0 |
| Total of all active and inactive participants | 2009-04-01 | 143 |
| Total participants | 2009-04-01 | 143 |
| Measure | Date | Value |
|---|
| 2011 : PT SERVICES INC EMPLOYEE BENEFIT TRUST 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-03-31 | $240,632 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-03-31 | $240,632 |
| Total income from all sources (including contributions) | 2011-03-31 | $1,609,743 |
| Total of all expenses incurred | 2011-03-31 | $1,609,251 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-03-31 | $1,507,165 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-03-31 | $1,609,251 |
| Value of total assets at end of year | 2011-03-31 | $257,531 |
| Value of total assets at beginning of year | 2011-03-31 | $257,039 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-03-31 | $102,086 |
| Total interest from all sources | 2011-03-31 | $492 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-03-31 | No |
| Was this plan covered by a fidelity bond | 2011-03-31 | No |
| If this is an individual account plan, was there a blackout period | 2011-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-03-31 | No |
| Administrative expenses (other) incurred | 2011-03-31 | $26,312 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-03-31 | No |
| Value of net income/loss | 2011-03-31 | $492 |
| Value of net assets at end of year (total assets less liabilities) | 2011-03-31 | $16,899 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-03-31 | $16,407 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-03-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-03-31 | $257,531 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-03-31 | $257,039 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-03-31 | $257,039 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-03-31 | $492 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-03-31 | No |
| Contributions received in cash from employer | 2011-03-31 | $1,609,251 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-03-31 | $1,507,165 |
| Contract administrator fees | 2011-03-31 | $75,774 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-03-31 | $240,632 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-03-31 | $240,632 |
| Did the plan have assets held for investment | 2011-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-03-31 | No |
| 2023: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2023 form 5500 responses |
|---|
| 2023-04-01 | Type of plan entity | Single employer plan |
| 2023-04-01 | Plan funding arrangement – Insurance | Yes |
| 2023-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2022 form 5500 responses |
|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2020 form 5500 responses |
|---|
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Submission has been amended | No |
| 2019-04-01 | This submission is the final filing | No |
| 2019-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-04-01 | Plan is a collectively bargained plan | No |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Submission has been amended | No |
| 2018-04-01 | This submission is the final filing | No |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-04-01 | Plan is a collectively bargained plan | No |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Submission has been amended | No |
| 2017-04-01 | This submission is the final filing | No |
| 2017-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-04-01 | Plan is a collectively bargained plan | No |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Submission has been amended | No |
| 2016-04-01 | This submission is the final filing | No |
| 2016-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-04-01 | Plan is a collectively bargained plan | No |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Submission has been amended | No |
| 2015-04-01 | This submission is the final filing | No |
| 2015-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-04-01 | Plan is a collectively bargained plan | No |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Submission has been amended | No |
| 2014-04-01 | This submission is the final filing | No |
| 2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-04-01 | Plan is a collectively bargained plan | No |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Submission has been amended | No |
| 2013-04-01 | This submission is the final filing | No |
| 2013-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-04-01 | Plan is a collectively bargained plan | No |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Submission has been amended | No |
| 2012-04-01 | This submission is the final filing | No |
| 2012-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-04-01 | Plan is a collectively bargained plan | No |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Submission has been amended | No |
| 2011-04-01 | This submission is the final filing | Yes |
| 2011-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-04-01 | Plan is a collectively bargained plan | No |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Submission has been amended | Yes |
| 2010-04-01 | This submission is the final filing | No |
| 2010-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-04-01 | Plan is a collectively bargained plan | No |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: PT SERVICES INC EMPLOYEE BENEFIT TRUST 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Submission has been amended | No |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-04-01 | Plan is a collectively bargained plan | No |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan funding arrangement – Trust | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement - Trust | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 468457 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $20,647 | | 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 | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS, HOSPITAL | | Welfare Benefit Premiums Paid to Carrier | USD $180,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 468457 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $15,018 | | 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 | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $138,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $14,385 | | Total amount of fees paid to insurance company | USD $7,212 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $14,385 | | Amount paid for insurance broker fees | 7212 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 2 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $25,539 | | Total amount of fees paid to insurance company | USD $4,517 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,539 | | Amount paid for insurance broker fees | 4517 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $14,774 | | Total amount of fees paid to insurance company | USD $7,129 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $14,774 | | Amount paid for insurance broker fees | 7129 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC. | | Insurance broker organization code? | 3 |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 2 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $27,322 | | Total amount of fees paid to insurance company | USD $4,296 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,322 | | Amount paid for insurance broker fees | 4296 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC. | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 2 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $14,220 | | Total amount of fees paid to insurance company | USD $6,021 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $14,220 | | Amount paid for insurance broker fees | 6021 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE BENEFITS AGENCY INC |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 1 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $26,894 | | Total amount of fees paid to insurance company | USD $2,344 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,894 | | Amount paid for insurance broker fees | 2344 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC . | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE BENEFITS AGENCY INC |
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| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 1 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $23,934 | | Total amount of fees paid to insurance company | USD $2,925 | | 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 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 | Yes | | 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 | | Commission paid to Insurance Broker | USD $23,934 | | Amount paid for insurance broker fees | 2925 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 2 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $9,474 | | Total amount of fees paid to insurance company | USD $4,055 | | 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 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 | Yes | | 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 | | Commission paid to Insurance Broker | USD $9,474 | | Amount paid for insurance broker fees | 4055 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 2 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $10,125 | | Total amount of fees paid to insurance company | USD $3,333 | | 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 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $10,125 | | Amount paid for insurance broker fees | 3333 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
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| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 1 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $23,368 | | Total amount of fees paid to insurance company | USD $3,059 | | 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 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 | Yes | | 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 | | Commission paid to Insurance Broker | USD $23,368 | | Amount paid for insurance broker fees | 3059 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 2 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $24,746 | | Total amount of fees paid to insurance company | USD $3,060 | | 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 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 | Yes | | 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 | | Commission paid to Insurance Broker | USD $24,746 | | Amount paid for insurance broker fees | 3060 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $10,052 | | Total amount of fees paid to insurance company | USD $5,171 | | 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 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $10,052 | | Amount paid for insurance broker fees | 5171 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00468457 |
| Policy instance | 1 |
| Insurance contract or identification number | 00468457 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $10,189 | | Total amount of fees paid to insurance company | USD $2,846 | | 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 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 | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | 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 | | Commission paid to Insurance Broker | USD $10,189 | | Amount paid for insurance broker fees | 2846 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 2 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $26,213 | | Total amount of fees paid to insurance company | USD $2,912 | | 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 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 | Yes | | 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 | | Commission paid to Insurance Broker | USD $26,213 | | Amount paid for insurance broker fees | 2912 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES ETC | | Insurance broker organization code? | 3 | | Insurance broker name | CORPORATE ONE AGENCY INC. |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 173 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $9,487 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 2 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $26,926 | | Total amount of fees paid to insurance company | USD $1,821 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 766203G |
| Policy instance | 2 |
| Insurance contract or identification number | 766203G | | Number of Individuals Covered | 176 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-06-30 | | Total amount of commissions paid to insurance broker | USD $9,742 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 1 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $8,313 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 753195 |
| Policy instance | 3 |
| Insurance contract or identification number | 753195 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $26,312 | | Total amount of fees paid to insurance company | USD $67,461 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
