HEARTLAND DENTAL CARE, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN
Measure | Date | Value |
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2015: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 5,212 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 5,138 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 45 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 377 |
Total of all active and inactive participants | 2015-01-01 | 5,560 |
2014: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 3,279 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 4,511 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 73 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 154 |
Total of all active and inactive participants | 2014-01-01 | 4,738 |
2013: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 2,709 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 3,218 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 51 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 88 |
Total of all active and inactive participants | 2013-01-01 | 3,357 |
2012: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 2,024 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 2,581 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 50 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 75 |
Total of all active and inactive participants | 2012-01-01 | 2,706 |
2011: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 1,774 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,985 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 30 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 79 |
Total of all active and inactive participants | 2011-01-01 | 2,094 |
2009: HEARTLAND DENTAL, LLC WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 1,362 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,545 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 34 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 53 |
Total of all active and inactive participants | 2009-01-01 | 1,632 |
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 3384 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $6,350 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,350 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 2 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 7287 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $28,761 | Total amount of fees paid to insurance company | USD $851 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $143,807 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,761 | Amount paid for insurance broker fees | 851 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 036-5512-00 |
Policy instance | 3 |
Insurance contract or identification number | 036-5512-00 | Number of Individuals Covered | 18 | Insurance policy start date | 2014-04-01 | Insurance policy end date | 2015-03-31 | Total amount of commissions paid to insurance broker | USD $188 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | BASIC AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,120 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $94 | Insurance broker organization code? | 3 | Insurance broker name | JAMES HOUGH |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10173049 |
Policy instance | 4 |
Insurance contract or identification number | 10173049 | Number of Individuals Covered | 382 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $63,126 | Total amount of fees paid to insurance company | USD $2,133 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $315,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63,126 | Amount paid for insurance broker fees | 2133 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 5 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 720 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $45,965 | Total amount of fees paid to insurance company | USD $1,693 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $229,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,965 | Amount paid for insurance broker fees | 1693 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0846897 |
Policy instance | 6 |
Insurance contract or identification number | 0846897 | Number of Individuals Covered | 256 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $19,990 | Total amount of fees paid to insurance company | USD $2,290 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $127,791 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,990 | Amount paid for insurance broker fees | 2290 | Additional information about fees paid to insurance broker | ENGAGEMENT CREDIT | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10173049 |
Policy instance | 4 |
Insurance contract or identification number | 10173049 | Number of Individuals Covered | 315 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $56,881 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $284,403 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,881 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 5 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 633 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $45,134 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $225,672 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,134 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 2 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 5571 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $22,688 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $113,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,688 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 036-5512-00 |
Policy instance | 3 |
Insurance contract or identification number | 036-5512-00 | Number of Individuals Covered | 18 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2014-03-31 | Total amount of commissions paid to insurance broker | USD $204 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | BASIC AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,297 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $102 | Insurance broker organization code? | 3 | Insurance broker name | HICKS, RICHARD B |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 3405 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,466 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,466 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10173049 |
Policy instance | 5 |
Insurance contract or identification number | 10173049 | Number of Individuals Covered | 297 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $30,752 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $153,762 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,752 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 3 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 639 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $26,025 | Total amount of fees paid to insurance company | USD $2,002 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $130,125 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,025 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2002 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 2 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 4276 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $17,952 | Total amount of fees paid to insurance company | USD $2,492 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $89,761 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,952 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2492 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 1872 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $4,787 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,787 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 036-5512-00 |
Policy instance | 4 |
Insurance contract or identification number | 036-5512-00 | Number of Individuals Covered | 20 | Insurance policy start date | 2012-04-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $206 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | BASIC AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $103 | Insurance broker organization code? | 3 | Insurance broker name | RICHARD B HICKS |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 1528 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $4,096 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,096 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 036-5512-00 |
Policy instance | 5 |
Insurance contract or identification number | 036-5512-00 | Number of Individuals Covered | 20 | Insurance policy start date | 2011-04-01 | Insurance policy end date | 2012-03-31 | Total amount of commissions paid to insurance broker | USD $186 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | BASIC AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,062 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $93 | Insurance broker organization code? | 3 | Insurance broker name | RICHARD B HICKS |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 4 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 167 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $10,812 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $61,605 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,812 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 3 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 3738 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $15,333 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $76,666 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,333 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | P15976-15979 |
Policy instance | 2 |
Insurance contract or identification number | P15976-15979 | Number of Individuals Covered | 3562 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $206,882 | Total amount of fees paid to insurance company | USD $35,210 | 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 $743,446 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $206,882 | Amount paid for insurance broker fees | 15580 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS BONUSES BASED ON BROKER/CONSULTANT VOLUME | Insurance broker organization code? | 3 | Insurance broker name | BEHNKE & CO. INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 4 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 131 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $6,010 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $40,069 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 3 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 2496 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $10,865 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $54,326 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | P15976-15979 |
Policy instance | 2 |
Insurance contract or identification number | P15976-15979 | Number of Individuals Covered | 2837 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $186,915 | Total amount of fees paid to insurance company | USD $14,061 | 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 $535,369 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 1189 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $3,488 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 036-5512-00 |
Policy instance | 5 |
Insurance contract or identification number | 036-5512-00 | Number of Individuals Covered | 22 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-03-31 | Total amount of commissions paid to insurance broker | USD $188 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | BASIC AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100001965 |
Policy instance | 4 |
Insurance contract or identification number | 40000100001965 | Number of Individuals Covered | 119 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $5,599 | Total amount of fees paid to insurance company | USD $2,564 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $37,327 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,599 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2564 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | BEHNKE AGENCY OF OHIO |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | P15976-15979 |
Policy instance | 2 |
Insurance contract or identification number | P15976-15979 | Number of Individuals Covered | 2422 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $152,753 | Total amount of fees paid to insurance company | USD $15,678 | 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 $390,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $152,753 | Amount paid for insurance broker fees | 15678 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | BEHNKE & CO. INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
Policy contract number | 12311715 |
Policy instance | 1 |
Insurance contract or identification number | 12311715 | Number of Individuals Covered | 965 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $3,111 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,111 | Insurance broker organization code? | 3 | Insurance broker name | BEHNKE & CO. OF OHIO |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10042950 |
Policy instance | 3 |
Insurance contract or identification number | 10042950 | Number of Individuals Covered | 2074 | Insurance policy start date | 2009-06-01 | Insurance policy end date | 2010-05-31 | Total amount of commissions paid to insurance broker | USD $9,685 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D & D | Welfare Benefit Premiums Paid to Carrier | USD $48,426 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,685 | Insurance broker organization code? | 3 | Insurance broker name | STEVEN J HOPP |
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