DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN
401k plan membership statisitcs for DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN
| Measure | Date | Value |
|---|
| 2022: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-10-01 | 241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 249 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 249 |
| 2021: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 83 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 251 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 251 |
| 2020: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 83 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 83 |
| 2019: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 119 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 119 |
| 2018: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 135 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 135 |
| 2017: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 123 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 123 |
| 2016: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 115 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 115 |
| 2015: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 118 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
| Total of all active and inactive participants | 2015-10-01 | 118 |
| 2014: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 115 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
| Total of all active and inactive participants | 2014-10-01 | 115 |
| 2013: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 124 |
| Total of all active and inactive participants | 2013-10-01 | 124 |
| 2012: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 116 |
| Total of all active and inactive participants | 2012-10-01 | 116 |
| 2011: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 116 |
| Total of all active and inactive participants | 2011-10-01 | 116 |
| 2010: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 108 |
| Number of retired or separated participants receiving benefits | 2010-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-10-01 | 0 |
| Total of all active and inactive participants | 2010-10-01 | 108 |
| Total participants | 2010-10-01 | 108 |
| 2009: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 110 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-10-01 | 0 |
| Total of all active and inactive participants | 2009-10-01 | 110 |
| Total participants | 2009-10-01 | 110 |
| 2008: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-10-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-10-01 | 115 |
| Number of retired or separated participants receiving benefits | 2008-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-10-01 | 0 |
| Total of all active and inactive participants | 2008-10-01 | 115 |
| Total participants | 2008-10-01 | 115 |
| 2007: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-10-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-10-01 | 106 |
| Number of retired or separated participants receiving benefits | 2007-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-10-01 | 0 |
| Total of all active and inactive participants | 2007-10-01 | 106 |
| Total participants | 2007-10-01 | 106 |
| 2006: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-10-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-10-01 | 110 |
| Number of retired or separated participants receiving benefits | 2006-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-10-01 | 0 |
| Total of all active and inactive participants | 2006-10-01 | 110 |
| Total participants | 2006-10-01 | 110 |
| 2022: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Submission has been amended | No |
| 2010-10-01 | This submission is the final filing | No |
| 2010-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-10-01 | Plan is a collectively bargained plan | No |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2008 form 5500 responses |
|---|
| 2008-10-01 | Type of plan entity | Single employer plan |
| 2008-10-01 | Submission has been amended | No |
| 2008-10-01 | This submission is the final filing | No |
| 2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-10-01 | Plan is a collectively bargained plan | No |
| 2008-10-01 | Plan funding arrangement – Insurance | Yes |
| 2008-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2007 form 5500 responses |
|---|
| 2007-10-01 | Type of plan entity | Single employer plan |
| 2007-10-01 | Submission has been amended | No |
| 2007-10-01 | This submission is the final filing | No |
| 2007-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-10-01 | Plan is a collectively bargained plan | No |
| 2007-10-01 | Plan funding arrangement – Insurance | Yes |
| 2007-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2006: DAKOTA MISSOURI VALLEY & WESTERN RAILROAD, INC HEALTH PLAN 2006 form 5500 responses |
|---|
| 2006-10-01 | Type of plan entity | Single employer plan |
| 2006-10-01 | Submission has been amended | No |
| 2006-10-01 | This submission is the final filing | No |
| 2006-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-10-01 | Plan is a collectively bargained plan | No |
| 2006-10-01 | Plan funding arrangement – Insurance | Yes |
| 2006-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2006-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2006-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
| Policy contract number | 699744 |
| Policy instance | 2 |
| Insurance contract or identification number | 699744 | | Number of Individuals Covered | 209 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $9,745 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $96,560 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,682 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 1 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $62,557 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,563,922 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,557 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
| Policy contract number | 699744 |
| Policy instance | 2 |
| Insurance contract or identification number | 699744 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $8,936 | | Welfare Benefit Premiums Paid to Carrier | USD $85,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,957 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 1 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 251 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $67,792 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,544,788 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,792 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
| Policy contract number | 699744 |
| Policy instance | 2 |
| Insurance contract or identification number | 699744 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $12,581 | | Welfare Benefit Premiums Paid to Carrier | USD $85,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,387 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 1 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $45,245 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,292,721 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,245 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
| Policy contract number | 699744 |
| Policy instance | 2 |
| Insurance contract or identification number | 699744 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $7,986 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,708 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,980 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 1 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $21,720 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,251,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,720 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 2 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $22,640 | | Welfare Benefit Premiums Paid to Carrier | USD $1,174,048 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,640 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
| Policy contract number | 0001024246 |
| Policy instance | 1 |
| Insurance contract or identification number | 0001024246 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $12,294 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,206 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,196 | | Additional information about fees paid to insurance broker | GENERAL AGENT | | Insurance broker organization code? | 3 |
|
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) |
| Policy contract number | HP040598 |
| Policy instance | 2 |
| Insurance contract or identification number | HP040598 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $23,020 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,147,438 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) |
| Policy contract number | 19583+ |
| Policy instance | 1 |
| Insurance contract or identification number | 19583+ | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Welfare Benefit Premiums Paid to Carrier | USD $194,473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
