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HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 401k Plan overview

Plan NameHEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY
Plan identification number 501

HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 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

HEKTOEN INSTITUTE LLC has sponsored the creation of one or more 401k plans.

Company Name:HEKTOEN INSTITUTE LLC
Employer identification number (EIN):362244897
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-09-01
5012021-09-01
5012021-09-01
5012020-09-01
5012020-09-01
5012019-09-01
5012019-09-01
5012018-09-01
5012018-09-01
5012017-09-01DENNIS RONOWSKI DENNIS RONOWSKI2019-03-19
5012017-09-01
5012017-09-01
5012016-09-01DENNIS RONOWSKI DENNIS RONOWSKI2018-03-12
5012016-09-01 DENNIS RONOWSKI2018-03-12
5012016-09-01 DENNIS RONOWSKI2018-03-12
5012015-09-01DENNIS RONOWSKI DENNIS RONOWSKI2017-03-23
5012015-09-01DENNIS RONOWSKI DENNIS RONOWSKI2017-03-23
5012015-09-01DENNIS RONOWSKI DENNIS RONOWSKI2017-03-22
5012015-09-01DENNIS RONOWSKI DENNIS RONOWSKI2017-03-23
5012014-09-01DENNIS RONOWSKI DENNIS RONOWSKI2016-03-09
5012014-09-01DENNIS RONOWSKI DENNIS RONOWSKI2016-03-09
5012014-09-01DENNIS RONOWSKI DENNIS RONOWSKI2016-03-09
5012013-09-01DENNIS RONOWSKI DENNIS RONOWSKI2015-03-17
5012012-11-01DENNIS RONOWSKI DENNIS RONOWSKI2014-03-21
5012012-09-01DENNIS RONOWSKI DENNIS RONOWSKI2014-03-21
5012012-01-01DENNIS RONOWSKI DENNIS RONOWSKI2013-03-15
5012011-09-01DENNIS RONOWSKI DENNIS RONOWSKI2013-03-15
5012011-01-01DENNIS RONOWSKI DENNIS RONOWSKI2012-03-23
5012010-01-01DENNIS RONOWSKI DENNIS RONOWSKI2011-03-28
5012009-11-01DENNIS RONOWSKI DENNIS RONOWSKI2011-03-23
5012009-11-01DENNIS RONOWSKI DENNIS RONOWSKI2011-03-23
5012009-09-01DENNIS RONOWSKI DENNIS RONOWSKI2011-03-28

Plan Statistics for HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY

401k plan membership statisitcs for HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY

Measure Date Value
2022: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2022 401k membership
Total participants, beginning-of-year2022-09-01388
Total number of active participants reported on line 7a of the Form 55002022-09-01364
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-01364
2021: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year2021-09-01386
Total number of active participants reported on line 7a of the Form 55002021-09-01313
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01313
2020: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year2020-09-01621
Total number of active participants reported on line 7a of the Form 55002020-09-01453
Number of retired or separated participants receiving benefits2020-09-011
Total of all active and inactive participants2020-09-01454
2019: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year2019-09-01573
Total number of active participants reported on line 7a of the Form 55002019-09-01621
Total of all active and inactive participants2019-09-01621
Number of retired or separated participants receiving benefits2019-09-010
2018: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year2018-09-01448
Total number of active participants reported on line 7a of the Form 55002018-09-01441
Number of retired or separated participants receiving benefits2018-09-011
Total of all active and inactive participants2018-09-01442
2017: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year2017-09-01105
Total number of active participants reported on line 7a of the Form 55002017-09-01115
Number of retired or separated participants receiving benefits2017-09-011
Total of all active and inactive participants2017-09-01116
2016: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year2016-09-0194
Total number of active participants reported on line 7a of the Form 55002016-09-01105
Total of all active and inactive participants2016-09-01105
2015: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year2015-09-01483
Total number of active participants reported on line 7a of the Form 55002015-09-01463
Total of all active and inactive participants2015-09-01463
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
2014: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year2014-09-01497
Total number of active participants reported on line 7a of the Form 55002014-09-01483
Total of all active and inactive participants2014-09-01483
2013: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year2013-09-01695
Total number of active participants reported on line 7a of the Form 55002013-09-01681
Total of all active and inactive participants2013-09-01681
2012: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year2012-11-01290
Total number of active participants reported on line 7a of the Form 55002012-11-01290
Total of all active and inactive participants2012-11-01290
Total participants, beginning-of-year2012-09-01695
Total number of active participants reported on line 7a of the Form 55002012-09-01695
Total of all active and inactive participants2012-09-01695
Total participants, beginning-of-year2012-01-01290
Total number of active participants reported on line 7a of the Form 55002012-01-01290
Total of all active and inactive participants2012-01-01290
2011: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year2011-09-01688
Total number of active participants reported on line 7a of the Form 55002011-09-01688
Total of all active and inactive participants2011-09-01688
Total participants, beginning-of-year2011-01-01280
Total number of active participants reported on line 7a of the Form 55002011-01-01280
Total of all active and inactive participants2011-01-01280
2010: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year2010-01-01275
Total number of active participants reported on line 7a of the Form 55002010-01-010
Total of all active and inactive participants2010-01-010
Total participants2010-01-010
2009: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year2009-11-01302
Total number of active participants reported on line 7a of the Form 55002009-11-010
Total of all active and inactive participants2009-11-010
Total participants2009-11-010
Total participants, beginning-of-year2009-09-01264
Total number of active participants reported on line 7a of the Form 55002009-09-01258
Total of all active and inactive participants2009-09-01258
Total participants2009-09-010

Form 5500 Responses for HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY

2022: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Submission has been amendedNo
2022-09-01This submission is the final filingNo
2022-09-01This return/report is a short plan year return/report (less than 12 months)No
2022-09-01Plan is a collectively bargained planNo
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: HEKTOEN INSTITUTE LLC DENTAL, LIFE SHORT AND LONG TERM DISABILITY 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5985589
Policy instance 4
Insurance contract or identification number5985589
Number of Individuals Covered364
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $59,281
Total amount of fees paid to insurance companyUSD $4,450
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $384,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,281
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA ADMIN FEES
Insurance broker organization code?6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218177
Policy instance 3
Insurance contract or identification number0218177
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $1,146
Total amount of fees paid to insurance companyUSD $371
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $551
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218176
Policy instance 2
Insurance contract or identification number0218176
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $1,588
Total amount of fees paid to insurance companyUSD $338
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $835
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $1,563
Total amount of fees paid to insurance companyUSD $488
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,348
Commission paid to Insurance BrokerUSD $705
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered313
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,057,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,058
Amount paid for insurance broker fees2550
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered388
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $49,051
Total amount of fees paid to insurance companyUSD $17,780
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,051
Amount paid for insurance broker fees13008
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218176
Policy instance 2
Insurance contract or identification number0218176
Number of Individuals Covered53
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $1,612
Total amount of fees paid to insurance companyUSD $359
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $894
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBASE COMISSIONS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218177
Policy instance 3
Insurance contract or identification number0218177
Number of Individuals Covered25
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $2,956
Total amount of fees paid to insurance companyUSD $387
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,750
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBASE COMMISSIONS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0218175
Policy instance 4
Insurance contract or identification number0218175
Number of Individuals Covered22
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $779
Total amount of fees paid to insurance companyUSD $318
Welfare Benefit Premiums Paid to CarrierUSD $4,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $383
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBASE COMISSIONS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered453
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $52,980
Total amount of fees paid to insurance companyUSD $17,781
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,980
Amount paid for insurance broker fees13942
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered385
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $64,938
Total amount of fees paid to insurance companyUSD $1,733
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,640,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 4
Insurance contract or identification numberP/H/B73958
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 3
Insurance contract or identification numberP/H/B73958
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Insurance broker organization code?2
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered417
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $61,338
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,449,112
Commission paid to Insurance BrokerUSD $61,338
Insurance broker organization code?2
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered621
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $55,332
Total amount of fees paid to insurance companyUSD $18,203
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Commission paid to Insurance BrokerUSD $55,332
Amount paid for insurance broker fees14564
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Insurance broker organization code?2
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered442
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $67,104
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,654,820
Commission paid to Insurance BrokerUSD $67,104
Insurance broker organization code?2
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 3
Insurance contract or identification numberP/H/B73958
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered472
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $59,818
Total amount of fees paid to insurance companyUSD $17,931
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $359,537
Commission paid to Insurance BrokerUSD $1,450
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30050637
Policy instance 1
Insurance contract or identification number30050637
Number of Individuals Covered115
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $663
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 3
Insurance contract or identification numberP/H/B73958
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered448
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $72,611
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,101,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $60,389
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $335,128
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 numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $57,682
Total amount of fees paid to insurance companyUSD $3,506
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $352,177
Commission paid to Insurance BrokerUSD $17,127
Amount paid for insurance broker fees3506
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameS WOLF & ASSOCIATES, INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $70,629
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,877,550
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $56,749
Total amount of fees paid to insurance companyUSD $6,397
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $372,409
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number30050637
Policy instance 1
Insurance contract or identification number30050637
Number of Individuals Covered75
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $453
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,556
Commission paid to Insurance BrokerUSD $453
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameSHELTON ADVISORS, INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered681
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $62,468
Total amount of fees paid to insurance companyUSD $4,543
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $362,624
Commission paid to Insurance BrokerUSD $14,459
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameSHELTON ADVISORS INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $70,727
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,954,749
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL137925
Policy instance 1
Insurance contract or identification numberGL137925
Number of Individuals Covered326
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $9,968
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $181,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,968
Insurance broker organization code?3
Insurance broker nameFIRST NONPROFIT INSURANCE AGENCY
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 2
Insurance contract or identification numberP/H/B73958
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $70,700
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,938,909
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 numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered695
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $25,551
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $198,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,724
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBENEFIT SERVICES PLUS INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL137925
Policy instance 1
Insurance contract or identification numberGL137925
Number of Individuals Covered290
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $10,590
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $222,051
Commission paid to Insurance BrokerUSD $10,590
Insurance broker organization code?3
Insurance broker nameFIRST NONPROFIT INSURANCE AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05985589
Policy instance 1
Insurance contract or identification numberTS05985589
Number of Individuals Covered688
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $23,712
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $198,154
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 number00400208
Policy instance 1
Insurance contract or identification number00400208
Number of Individuals Covered280
Insurance policy start date2011-01-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $6,592
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $131,831
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP/H/B73958
Policy instance 1
Insurance contract or identification numberP/H/B73958
Number of Individuals Covered555
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $64,859
Total amount of fees paid to insurance companyUSD $2,008
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,597,634
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 number00400208
Policy instance 1
Insurance contract or identification number00400208
Number of Individuals Covered275
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $9,068
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $181,363
Commission paid to Insurance BrokerUSD $9,068
Insurance broker organization code?3
Insurance broker nameFIRST NONPROFIT INSURANCE AGENCY

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