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OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 401k Plan overview

Plan NameOPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN
Plan identification number 501

OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN Benefits

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

401k Sponsoring company profile

OPPORTUNITY ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name:OPPORTUNITY ENTERPRISES, INC.
Employer identification number (EIN):351136833
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about OPPORTUNITY ENTERPRISES, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2002-06-14
Company Identification Number: 20021163324
Legal Registered Office Address: 13090 W 15th Dr

Golden
United States of America (USA)
80401

More information about OPPORTUNITY ENTERPRISES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01MARK FISHER
5012016-05-01MARK FISHER
5012015-05-01MARK FISHER
5012014-05-01MARK FISHER
5012013-05-01MARK FISHER
5012012-05-01MARK FISHER
5012011-05-01MARK FISHER
5012010-05-01MARK FISHER
5012009-05-01MARK FISHER

Plan Statistics for OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN

401k plan membership statisitcs for OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN

Measure Date Value
2022: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01134
Total number of active participants reported on line 7a of the Form 55002022-05-01128
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01128
2021: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01123
Total number of active participants reported on line 7a of the Form 55002021-05-01134
Total of all active and inactive participants2021-05-01134
Total participants2021-05-01134
2020: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01130
Total number of active participants reported on line 7a of the Form 55002020-05-01123
Total of all active and inactive participants2020-05-01123
Total participants2020-05-01123
2019: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01154
Total number of active participants reported on line 7a of the Form 55002019-05-01130
Total of all active and inactive participants2019-05-01130
Total participants2019-05-01130
2018: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01141
Total number of active participants reported on line 7a of the Form 55002018-05-01154
Total of all active and inactive participants2018-05-01154
Total participants2018-05-01154
2017: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01147
Total number of active participants reported on line 7a of the Form 55002017-05-01141
Total of all active and inactive participants2017-05-01141
Total participants2017-05-01141
2016: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01146
Total number of active participants reported on line 7a of the Form 55002016-05-01147
Total of all active and inactive participants2016-05-01147
Total participants2016-05-01147
2015: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01155
Total number of active participants reported on line 7a of the Form 55002015-05-01146
Total of all active and inactive participants2015-05-01146
Total participants2015-05-010
2014: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01229
Total number of active participants reported on line 7a of the Form 55002014-05-01155
Total of all active and inactive participants2014-05-01155
Total participants2014-05-010
2013: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01180
Total number of active participants reported on line 7a of the Form 55002013-05-01229
Total of all active and inactive participants2013-05-01229
Total participants2013-05-010
2012: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01120
Total number of active participants reported on line 7a of the Form 55002012-05-01180
Total of all active and inactive participants2012-05-01180
Total participants2012-05-010
2011: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01116
Total number of active participants reported on line 7a of the Form 55002011-05-01120
Total of all active and inactive participants2011-05-01120
Total participants2011-05-01120
2010: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01137
Total number of active participants reported on line 7a of the Form 55002010-05-01116
Total of all active and inactive participants2010-05-01116
Total participants2010-05-01116
2009: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01157
Total number of active participants reported on line 7a of the Form 55002009-05-01137
Total of all active and inactive participants2009-05-01137
Total participants2009-05-01137

Form 5500 Responses for OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN

2022: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: OPPORTUNITY ENTERPRISES, INC. BENEFITS PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number160627
Policy instance 3
Insurance contract or identification number160627
Number of Individuals Covered139
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $18,177
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,284
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977396
Policy instance 2
Insurance contract or identification number5977396
Number of Individuals Covered242
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $6,962
Total amount of fees paid to insurance companyUSD $1,899
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,962
Amount paid for insurance broker fees1899
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number477
Policy instance 1
Insurance contract or identification number477
Number of Individuals Covered128
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $6,585
Total amount of fees paid to insurance companyUSD $32,934
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $400,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees32934
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $6,585
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number477
Policy instance 1
Insurance contract or identification number477
Number of Individuals Covered134
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $6,124
Total amount of fees paid to insurance companyUSD $33,682
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees33682
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $6,124
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number160627
Policy instance 2
Insurance contract or identification number160627
Number of Individuals Covered107
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $22,451
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,435
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977396
Policy instance 3
Insurance contract or identification number5977396
Number of Individuals Covered267
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $6,414
Total amount of fees paid to insurance companyUSD $1,124
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,414
Amount paid for insurance broker fees1124
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-720999
Policy instance 2
Insurance contract or identification number136-720999
Number of Individuals Covered268
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $25,430
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,295
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0914390
Policy instance 1
Insurance contract or identification number0914390
Number of Individuals Covered123
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $35,464
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,468,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,464
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-720999
Policy instance 2
Insurance contract or identification number136-720999
Number of Individuals Covered286
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $22,801
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $145,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,699
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914390
Policy instance 1
Insurance contract or identification number914390
Number of Individuals Covered177
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $36,674
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $905,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,674
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914390
Policy instance 1
Insurance contract or identification number914390
Number of Individuals Covered192
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $36,058
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,453,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,762
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00359452
Policy instance 2
Insurance contract or identification number00359452
Number of Individuals Covered154
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,966
Total amount of fees paid to insurance companyUSD $11
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,255
Insurance broker organization code?3
Amount paid for insurance broker fees11
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00244137
Policy instance 1
Insurance contract or identification number00244137
Number of Individuals Covered131
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $39,358
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,452,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00244137
Policy instance 2
Insurance contract or identification number00244137
Number of Individuals Covered141
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $740
Total amount of fees paid to insurance companyUSD $90
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00244137
Policy instance 1
Insurance contract or identification number00244137
Number of Individuals Covered146
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $39,974
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,511,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,974
Insurance broker organization code?3
Insurance broker nameASSURED NEACE LUKENS INSURANCE AGCY
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00244137
Policy instance 2
Insurance contract or identification number00244137
Number of Individuals Covered139
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $1,028
Total amount of fees paid to insurance companyUSD $195
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,028
Amount paid for insurance broker fees195
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATION AND TRAINING
Insurance broker organization code?3
Insurance broker nameASSURED NEACE LUKENS INSURANCE AGCY
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number00244137
Policy instance 2
Insurance contract or identification number00244137
Number of Individuals Covered153
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $661
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $661
Insurance broker organization code?3
Insurance broker nameASSURED NEACE LUKENS INSURANCE AGCY
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00244137
Policy instance 1
Insurance contract or identification number00244137
Number of Individuals Covered155
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $41,976
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,654,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,976
Insurance broker organization code?3
Insurance broker nameASSURED NEACE LUKENS INSURANCE AGCY
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number744526
Policy instance 1
Insurance contract or identification number744526
Number of Individuals Covered229
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $31,193
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,309,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,351
Insurance broker organization code?3
Insurance broker nameASSURED NL INSURANCE AGENCY INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0744526
Policy instance 1
Insurance contract or identification number0744526
Number of Individuals Covered180
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $30,254
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,474,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,254
Insurance broker organization code?3
Insurance broker nameDAVID SPITLER
INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 )
Policy contract numberIIS 1664
Policy instance 1
Insurance contract or identification numberIIS 1664
Number of Individuals Covered120
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $13,554
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $270,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract numberIIS 1664
Policy instance 1
Insurance contract or identification numberIIS 1664
Number of Individuals Covered116
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $17,454
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $294,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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