RIVERSTONE GROUP INC. has sponsored the creation of one or more 401k plans.
Additional information about RIVERSTONE GROUP INC.
Submission information for form 5500 for 401k plan RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN
401k plan membership statisitcs for RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 348 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 325 |
| Total of all active and inactive participants | 2022-04-01 | 325 |
| 2021: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-04-01 | 345 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 348 |
| Total of all active and inactive participants | 2021-04-01 | 348 |
| 2020: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 349 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 345 |
| Total of all active and inactive participants | 2020-04-01 | 345 |
| 2019: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 326 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 349 |
| Total of all active and inactive participants | 2019-04-01 | 349 |
| 2018: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 324 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 326 |
| Total of all active and inactive participants | 2018-04-01 | 326 |
| 2017: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 324 |
| Total of all active and inactive participants | 2017-04-01 | 324 |
| 2016: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 319 |
| Total of all active and inactive participants | 2016-04-01 | 319 |
| 2015: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 307 |
| Total of all active and inactive participants | 2015-04-01 | 307 |
| 2014: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 263 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 277 |
| Total of all active and inactive participants | 2014-04-01 | 277 |
| 2013: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 263 |
| Total of all active and inactive participants | 2013-04-01 | 263 |
| 2012: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 247 |
| Total of all active and inactive participants | 2012-04-01 | 247 |
| 2011: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 264 |
| Total of all active and inactive participants | 2011-04-01 | 264 |
| 2009: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 261 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 266 |
| Total of all active and inactive participants | 2009-04-01 | 266 |
| 2022: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 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 |
| 2021: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 funding arrangement – General assets of the sponsor | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 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: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 funding arrangement – General assets of the sponsor | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Submission has been amended | Yes |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Submission has been amended | Yes |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 benefit arrangement – Insurance | Yes |
| 2011: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 benefit arrangement – Insurance | Yes |
| 2009: RIVERSTONE GROUP INC. & AFFILIATES GROUP HEALTH 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 benefit arrangement – Insurance | Yes |
| LIBERTY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61492 ) |
| Policy contract number | 5722272 |
| Policy instance | 2 |
| Insurance contract or identification number | 5722272 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $3,360 | | Total amount of fees paid to insurance company | USD $3,121 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $165,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,360 | | Amount paid for insurance broker fees | 3121 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| FAIR AMERICAN INS AND REINS CO. (National Association of Insurance Commissioners NAIC id number: 35157 ) |
| Policy contract number | 10490-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 10490-00 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $168,448 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $656,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 107903 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 |
|
| LIBERTY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61492 ) |
| Policy contract number | 5722272 |
| Policy instance | 2 |
| Insurance contract or identification number | 5722272 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $4,923 | | Total amount of fees paid to insurance company | USD $6,782 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,923 | | Amount paid for insurance broker fees | 6782 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 10490-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 10490-00 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $160,749 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $802,550 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 103087 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 |
|
| LIBERTY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61492 ) |
| Policy contract number | 5722272 |
| Policy instance | 2 |
| Insurance contract or identification number | 5722272 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $3,163 | | Total amount of fees paid to insurance company | USD $7,527 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $202,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,163 | | Amount paid for insurance broker fees | 7527 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 10490-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 10490-00 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $225,856 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $797,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 166646 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTATION | | Insurance broker organization code? | 5 |
|
| LIBERTY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61492 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 349 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $2,046 | | Total amount of fees paid to insurance company | USD $174 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,046 | | Amount paid for insurance broker fees | 174 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 10490-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 10490-00 | | Number of Individuals Covered | 349 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $36,985 | | Total amount of fees paid to insurance company | USD $170,757 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $546,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 93482 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $36,985 |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 326 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $140,648 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $295,411 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 84271 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $143,932 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $176,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 86465 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | HFN |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $126,959 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $204,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 73883 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | HFN |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $110,024 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $189,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 68892 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | HFN |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $13,661 | | Total amount of fees paid to insurance company | USD $81,195 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $164,863 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,814 | | Amount paid for insurance broker fees | 38160 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | PCHS |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $17,360 | | Total amount of fees paid to insurance company | USD $72,900 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,659 | | Amount paid for insurance broker fees | 49032 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | CELTIC INSURANCE COMPANY |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $16,782 | | Total amount of fees paid to insurance company | USD $71,308 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,028 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROSVENOR ACCIDENT & HEALTH (National Association of Insurance Commissioners NAIC id number: 28987 ) |
| Policy contract number | Y53 |
| Policy instance | 1 |
| Insurance contract or identification number | Y53 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $17,228 | | Total amount of fees paid to insurance company | USD $68,026 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $154,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,614 | | Amount paid for insurance broker fees | 45581 | | Additional information about fees paid to insurance broker | CONTRACT ADMINISTRATION | | Insurance broker organization code? | 5 | | Insurance broker name | GLOBAL CARE |
|
