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ACCURATE METAL MACHINING INC. HEALTH INSURANCE 401k Plan overview

Plan NameACCURATE METAL MACHINING INC. HEALTH INSURANCE
Plan identification number 503

ACCURATE METAL MACHINING INC. HEALTH INSURANCE Benefits

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

401k Sponsoring company profile

ACCURATE METAL MACHINING INC. has sponsored the creation of one or more 401k plans.

Company Name:ACCURATE METAL MACHINING INC.
Employer identification number (EIN):341193166
NAIC Classification:333510

Additional information about ACCURATE METAL MACHINING INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1976-07-12
Company Identification Number: 484101
Legal Registered Office Address: 4445 HAMANN PKWY.
-
WILLOUGHBY
United States of America (USA)
44094

More information about ACCURATE METAL MACHINING INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACCURATE METAL MACHINING INC. HEALTH INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-10-01
5032020-10-01
5032019-10-01
5032018-10-01
5032017-10-01
5032016-10-01MARTHA JUDY
5032015-10-01MARTHA JUDY
5032014-10-01MARTHA JUDY
5032013-10-01EVA SZANTHO
5032012-10-01EVA SZANTHO
5032011-10-01EVA SZANTHO
5032009-10-01EVA SZANTHO

Plan Statistics for ACCURATE METAL MACHINING INC. HEALTH INSURANCE

401k plan membership statisitcs for ACCURATE METAL MACHINING INC. HEALTH INSURANCE

Measure Date Value
2021: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-10-01378
Total number of active participants reported on line 7a of the Form 55002021-10-01404
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01404
2020: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-10-01408
Total number of active participants reported on line 7a of the Form 55002020-10-01378
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01378
2019: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-10-01429
Total number of active participants reported on line 7a of the Form 55002019-10-01408
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01408
2018: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-10-01451
Total number of active participants reported on line 7a of the Form 55002018-10-01429
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01429
2017: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-10-01400
Total number of active participants reported on line 7a of the Form 55002017-10-01451
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01451
2016: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-10-01398
Total number of active participants reported on line 7a of the Form 55002016-10-01400
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01400
2015: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-10-01415
Total number of active participants reported on line 7a of the Form 55002015-10-01398
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 participants2015-10-01398
2014: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-10-01452
Total number of active participants reported on line 7a of the Form 55002014-10-01415
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01415
2013: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-10-01417
Total number of active participants reported on line 7a of the Form 55002013-10-01452
Total of all active and inactive participants2013-10-01452
2012: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-10-01438
Total number of active participants reported on line 7a of the Form 55002012-10-01417
Total of all active and inactive participants2012-10-01417
2011: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-10-01306
Total number of active participants reported on line 7a of the Form 55002011-10-01438
Total of all active and inactive participants2011-10-01438
Total participants2011-10-01438
2009: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-10-01350
Total number of active participants reported on line 7a of the Form 55002009-10-01342
Total of all active and inactive participants2009-10-01342
Total participants2009-10-01342

Financial Data on ACCURATE METAL MACHINING INC. HEALTH INSURANCE

Measure Date Value
2022 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2022 401k financial data
Total income from all sources2022-09-30$0
Total plan assets at end of year2022-09-30$0
Total plan assets at beginning of year2022-09-30$0
Net plan assets at end of year (total assets less liabilities)2022-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-09-30$0
2021 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2021 401k financial data
Total income from all sources2021-09-30$0
Total plan assets at end of year2021-09-30$0
Total plan assets at beginning of year2021-09-30$0
Net plan assets at end of year (total assets less liabilities)2021-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-09-30$0
2020 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2020 401k financial data
Total income from all sources2020-09-30$0
Total plan assets at end of year2020-09-30$0
Total plan assets at beginning of year2020-09-30$0
Net plan assets at end of year (total assets less liabilities)2020-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-09-30$0
2019 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2019 401k financial data
Total income from all sources2019-09-30$0
Total plan assets at end of year2019-09-30$0
Total plan assets at beginning of year2019-09-30$0
Net plan assets at end of year (total assets less liabilities)2019-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2019-09-30$0
2017 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2017 401k financial data
Total income from all sources2017-09-30$0
Total plan assets at end of year2017-09-30$0
Total plan assets at beginning of year2017-09-30$0
Net plan assets at end of year (total assets less liabilities)2017-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-09-30$0
2016 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2016 401k financial data
Total income from all sources2016-09-30$0
Total plan assets at end of year2016-09-30$0
Total plan assets at beginning of year2016-09-30$0
Net plan assets at end of year (total assets less liabilities)2016-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$0
2015 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2015 401k financial data
Total income from all sources2015-09-30$0
Total plan assets at end of year2015-09-30$0
Total plan assets at beginning of year2015-09-30$0
Net plan assets at end of year (total assets less liabilities)2015-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$0
2014 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2014 401k financial data
Total income from all sources2014-09-30$0
Total plan assets at end of year2014-09-30$0
Total plan assets at beginning of year2014-09-30$0
Net plan assets at end of year (total assets less liabilities)2014-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$0
2013 : ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2013 401k financial data
Total income from all sources2013-09-30$0
Total plan assets at end of year2013-09-30$0
Total plan assets at beginning of year2013-09-30$0
Net plan assets at end of year (total assets less liabilities)2013-09-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$0

Form 5500 Responses for ACCURATE METAL MACHINING INC. HEALTH INSURANCE

2021: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 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: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedYes
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: ACCURATE METAL MACHINING INC. HEALTH INSURANCE 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered404
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $58,099
Total amount of fees paid to insurance companyUSD $3,348
Welfare Benefit Premiums Paid to CarrierUSD $2,798,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,099
Amount paid for insurance broker fees3348
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered242
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $43,395
Total amount of fees paid to insurance companyUSD $13,445
Welfare Benefit Premiums Paid to CarrierUSD $428,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,950
Amount paid for insurance broker fees13445
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered408
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $41,763
Total amount of fees paid to insurance companyUSD $4,209
Welfare Benefit Premiums Paid to CarrierUSD $2,522,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,763
Amount paid for insurance broker fees4209
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered201
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $20,549
Total amount of fees paid to insurance companyUSD $14,405
Welfare Benefit Premiums Paid to CarrierUSD $293,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,549
Amount paid for insurance broker fees14405
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered408
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $39,758
Welfare Benefit Premiums Paid to CarrierUSD $2,542,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,758
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered201
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $16,835
Total amount of fees paid to insurance companyUSD $11,791
Welfare Benefit Premiums Paid to CarrierUSD $321,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,835
Amount paid for insurance broker fees11791
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered451
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $43,983
Total amount of fees paid to insurance companyUSD $4,347
Welfare Benefit Premiums Paid to CarrierUSD $2,934,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,983
Amount paid for insurance broker fees4347
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered201
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $16,811
Total amount of fees paid to insurance companyUSD $11,350
Welfare Benefit Premiums Paid to CarrierUSD $321,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,811
Amount paid for insurance broker fees11350
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered451
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $34,034
Total amount of fees paid to insurance companyUSD $3,006
Welfare Benefit Premiums Paid to CarrierUSD $2,640,053
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 number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered201
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,573
Total amount of fees paid to insurance companyUSD $11,019
Welfare Benefit Premiums Paid to CarrierUSD $292,386
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 number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered175
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $15,404
Total amount of fees paid to insurance companyUSD $10,130
Welfare Benefit Premiums Paid to CarrierUSD $248,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,375
Amount paid for insurance broker fees10130
Insurance broker organization code?3
Insurance broker nameTHE JAMES B OSWALD COMPANY
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered415
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $41,530
Total amount of fees paid to insurance companyUSD $458
Welfare Benefit Premiums Paid to CarrierUSD $2,042,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,530
Amount paid for insurance broker fees458
Insurance broker organization code?3
Insurance broker namePLANCORP/VANTAGE BENEFIT ADVISORS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00483676
Policy instance 1
Insurance contract or identification number00483676
Number of Individuals Covered188
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $14,821
Total amount of fees paid to insurance companyUSD $7,158
Welfare Benefit Premiums Paid to CarrierUSD $231,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,821
Amount paid for insurance broker fees7158
Insurance broker organization code?3
Insurance broker namePLANCORP/VANTAGE BENEFIT ADVIS
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered452
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $41,296
Total amount of fees paid to insurance companyUSD $3,440
Welfare Benefit Premiums Paid to CarrierUSD $2,103,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,296
Amount paid for insurance broker fees3440
Insurance broker organization code?3
Insurance broker namePLANCORP/VANTAGE BENEFIT ADVISORS
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract number00172028
Policy instance 2
Insurance contract or identification number00172028
Number of Individuals Covered417
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $40,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,165
Insurance broker namePLANCORP/VANTAGE BENEFIT ADVISORS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number000L8313
Policy instance 1
Insurance contract or identification number000L8313
Number of Individuals Covered178
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,965
Insurance broker namePLANCORP/VANTAGE BENEFIT ADVIS
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1011824
Policy instance 3
Insurance contract or identification number1011824
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,790
Insurance broker nameVANTAGE FINANCIAL GROUP INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number174105
Policy instance 4
Insurance contract or identification number174105
Number of Individuals Covered438
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $37,507
Total amount of fees paid to insurance companyUSD $3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,507
Amount paid for insurance broker fees3
Insurance broker nameVANTAGE FINANCIAL GROUP INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number174105
Policy instance 3
Insurance contract or identification number174105
Number of Individuals Covered438
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $37,507
Welfare Benefit Premiums Paid to CarrierUSD $2,080,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1011824
Policy instance 2
Insurance contract or identification number1011824
Number of Individuals Covered415
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $9,765
Total amount of fees paid to insurance companyUSD $1,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12701199
Policy instance 1
Insurance contract or identification number12701199
Number of Individuals Covered163
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,522
Welfare Benefit Premiums Paid to CarrierUSD $35,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05724946
Policy instance 2
Insurance contract or identification numberTM05724946
Number of Individuals Covered299
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number174105
Policy instance 3
Insurance contract or identification number174105
Number of Individuals Covered306
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $26,501
Welfare Benefit Premiums Paid to CarrierUSD $1,640,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1011824
Policy instance 1
Insurance contract or identification number1011824
Number of Individuals Covered164
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $5,989
Total amount of fees paid to insurance companyUSD $2,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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