BIG C LUMBER COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BIG C LUMBER COMPANY, INC. MEDICAL PLAN
401k plan membership statisitcs for BIG C LUMBER COMPANY, INC. MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2023: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-04-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-04-01 | 229 |
| Number of retired or separated participants receiving benefits | 2023-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2023-04-01 | 10 |
| Total of all active and inactive participants | 2023-04-01 | 240 |
| 2022: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 216 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 223 |
| 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 | 10 |
| Total of all active and inactive participants | 2022-04-01 | 233 |
| 2021: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-04-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 216 |
| Number of retired or separated participants receiving benefits | 2021-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-04-01 | 0 |
| Total of all active and inactive participants | 2021-04-01 | 216 |
| 2020: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 219 |
| 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 | 14 |
| Total of all active and inactive participants | 2020-04-01 | 233 |
| 2019: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 244 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 218 |
| Number of retired or separated participants receiving benefits | 2019-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-04-01 | 12 |
| Total of all active and inactive participants | 2019-04-01 | 230 |
| 2018: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 239 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 229 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2018-04-01 | 13 |
| Total of all active and inactive participants | 2018-04-01 | 244 |
| 2017: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 235 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 229 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 10 |
| Total of all active and inactive participants | 2017-04-01 | 239 |
| 2016: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 224 |
| Number of retired or separated participants receiving benefits | 2016-04-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2016-04-01 | 9 |
| Total of all active and inactive participants | 2016-04-01 | 235 |
| 2015: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 223 |
| Number of retired or separated participants receiving benefits | 2015-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-04-01 | 9 |
| Total of all active and inactive participants | 2015-04-01 | 233 |
| 2014: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 200 |
| Number of retired or separated participants receiving benefits | 2014-04-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2014-04-01 | 4 |
| Total of all active and inactive participants | 2014-04-01 | 206 |
| 2013: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 187 |
| Number of retired or separated participants receiving benefits | 2013-04-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2013-04-01 | 5 |
| Total of all active and inactive participants | 2013-04-01 | 195 |
| 2012: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 193 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 192 |
| Number of retired or separated participants receiving benefits | 2012-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2012-04-01 | 4 |
| Total of all active and inactive participants | 2012-04-01 | 197 |
| 2011: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 191 |
| Number of retired or separated participants receiving benefits | 2011-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-04-01 | 1 |
| Total of all active and inactive participants | 2011-04-01 | 193 |
| 2009: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 181 |
| Number of retired or separated participants receiving benefits | 2009-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-04-01 | 6 |
| Total of all active and inactive participants | 2009-04-01 | 187 |
| 2023: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 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 benefit arrangement – Insurance | Yes |
| 2022: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 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 benefit arrangement – Insurance | Yes |
| 2021: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2021 form 5500 responses |
|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 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 benefit arrangement – Insurance | Yes |
| 2019: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: BIG C LUMBER COMPANY, INC. MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40703 |
| Policy instance | 3 |
| Insurance contract or identification number | HCCLOT40703 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $4,724 | | Total amount of fees paid to insurance company | USD $638 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $47,239 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $42,519 | | Total amount of fees paid to insurance company | USD $90,509 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $696,825 | | 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 | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 300 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $5,876 | | Total amount of fees paid to insurance company | USD $3,289 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $77,556 | | 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 | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $5,225 | | Total amount of fees paid to insurance company | USD $2,215 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $69,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,225 | | Amount paid for insurance broker fees | 2215 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $41,596 | | Total amount of fees paid to insurance company | USD $85,850 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $476,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 85850 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $41,596 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40703 |
| Policy instance | 3 |
| Insurance contract or identification number | HCCLOT40703 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $4,653 | | Total amount of fees paid to insurance company | USD $625 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $46,526 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,653 | | Amount paid for insurance broker fees | 625 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40703 |
| Policy instance | 3 |
| Insurance contract or identification number | HCCLOT40703 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $4,711 | | Total amount of fees paid to insurance company | USD $848 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $47,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,355 | | Amount paid for insurance broker fees | 848 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $41,926 | | Total amount of fees paid to insurance company | USD $74,823 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $540,745 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 74823 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $41,926 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 286 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $4,623 | | Total amount of fees paid to insurance company | USD $1,752 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $61,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,623 | | Amount paid for insurance broker fees | 1752 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40703 |
| Policy instance | 3 |
| Insurance contract or identification number | HCCLOT40703 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $4,712 | | Total amount of fees paid to insurance company | USD $848 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $47,124 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,356 | | Amount paid for insurance broker fees | 848 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $39,480 | | Total amount of fees paid to insurance company | USD $72,841 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $557,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 72841 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $39,480 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $4,961 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $66,405 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,961 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT40703 |
| Policy instance | 3 |
| Insurance contract or identification number | HCCLOT40703 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $4,949 | | Total amount of fees paid to insurance company | USD $891 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $49,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,477 | | Amount paid for insurance broker fees | 891 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $41,265 | | Total amount of fees paid to insurance company | USD $77,223 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $585,251 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 77223 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $41,265 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $4,683 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $63,959 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,683 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 290 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $4,777 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $66,994 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,777 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $42,765 | | Total amount of fees paid to insurance company | USD $77,772 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $466,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 77772 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $42,765 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 9476506 |
| Policy instance | 3 |
| Insurance contract or identification number | 9476506 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $5,318 | | Total amount of fees paid to insurance company | USD $957 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $53,185 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,656 | | Amount paid for insurance broker fees | 957 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-5107 |
| Policy instance | 3 |
| Insurance contract or identification number | 947-5107 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $5,248 | | Total amount of fees paid to insurance company | USD $944 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $47,194 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,624 | | Amount paid for insurance broker fees | 944 | | Insurance broker organization code? | 3 | | Insurance broker name | THE HEALY GROUP |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL17020 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL17020 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $40,995 | | Total amount of fees paid to insurance company | USD $71,942 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $387,643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 71942 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $40,995 | | Insurance broker name | THE HEALY GROUP |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 357978 |
| Policy instance | 1 |
| Insurance contract or identification number | 357978 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $4,195 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $58,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,195 | | Insurance broker organization code? | 3 | | Insurance broker name | THE HEALY GROUP |
|
