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MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 401k Plan overview

Plan NameMEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN
Plan identification number 501

MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

MEMORIAL HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:MEMORIAL HEALTH SYSTEM
Employer identification number (EIN):371110690
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01ROBERT W KAY ROBERT W KAY2018-09-18
5012016-01-01ROBERT W KAY ROBERT W KAY2017-10-12
5012015-01-01ROBERT W KAY ROBERT W KAY2016-10-06
5012014-01-01ROBERT W KAY ROBERT W KAY2015-10-02
5012013-01-01ROBERT W KAY ROBERT W KAY2014-09-30
5012012-01-01ROBERT W KAY ROBERT W KAY2013-09-30
5012011-01-01ROBERT W KAY ROBERT W KAY2012-10-09
5012010-01-01ROBERT W KAY ROBERT W KAY2011-09-29
5012009-01-01ROBERT W KAY ROBERT W KAY2010-10-13
5012009-01-01ROBERT W KAY ROBERT W KAY2010-10-13

Plan Statistics for MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN

401k plan membership statisitcs for MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN

Measure Date Value
2023: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-017,378
Total number of active participants reported on line 7a of the Form 55002023-01-016,926
Number of retired or separated participants receiving benefits2023-01-0149
Total of all active and inactive participants2023-01-016,975
2022: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017,135
Total number of active participants reported on line 7a of the Form 55002022-01-017,063
Number of retired or separated participants receiving benefits2022-01-0181
Total of all active and inactive participants2022-01-017,144
2021: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-016,834
Total number of active participants reported on line 7a of the Form 55002021-01-017,088
Number of retired or separated participants receiving benefits2021-01-0147
Total of all active and inactive participants2021-01-017,135
2020: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,506
Total number of active participants reported on line 7a of the Form 55002020-01-015,120
Number of retired or separated participants receiving benefits2020-01-0151
Total of all active and inactive participants2020-01-015,171
2019: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-014,334
Total number of active participants reported on line 7a of the Form 55002019-01-014,197
Number of retired or separated participants receiving benefits2019-01-0128
Total of all active and inactive participants2019-01-014,225
2018: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-015,051
Total number of active participants reported on line 7a of the Form 55002018-01-014,902
Number of retired or separated participants receiving benefits2018-01-0147
Total of all active and inactive participants2018-01-014,949
2017: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-015,160
Total number of active participants reported on line 7a of the Form 55002017-01-015,010
Number of retired or separated participants receiving benefits2017-01-0162
Total of all active and inactive participants2017-01-015,072
2016: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-015,523
Total number of active participants reported on line 7a of the Form 55002016-01-015,522
Number of retired or separated participants receiving benefits2016-01-0143
Total of all active and inactive participants2016-01-015,565
2015: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-014,263
Total number of active participants reported on line 7a of the Form 55002015-01-014,709
Number of retired or separated participants receiving benefits2015-01-0138
Total of all active and inactive participants2015-01-014,747
2014: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-014,574
Total number of active participants reported on line 7a of the Form 55002014-01-014,674
Number of retired or separated participants receiving benefits2014-01-0138
Total of all active and inactive participants2014-01-014,712
2013: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,511
Total number of active participants reported on line 7a of the Form 55002013-01-014,511
Number of retired or separated participants receiving benefits2013-01-0163
Total of all active and inactive participants2013-01-014,574
2012: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-014,511
Total number of active participants reported on line 7a of the Form 55002012-01-014,450
Number of retired or separated participants receiving benefits2012-01-0161
Total of all active and inactive participants2012-01-014,511
2011: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014,530
Total number of active participants reported on line 7a of the Form 55002011-01-014,446
Number of retired or separated participants receiving benefits2011-01-0165
Total of all active and inactive participants2011-01-014,511
2010: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-014,388
Total number of active participants reported on line 7a of the Form 55002010-01-014,449
Number of retired or separated participants receiving benefits2010-01-0181
Total of all active and inactive participants2010-01-014,530
2009: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014,073
Total number of active participants reported on line 7a of the Form 55002009-01-014,185
Number of retired or separated participants receiving benefits2009-01-0169
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014,254

Form 5500 Responses for MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN

2023: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: MEMORIAL HEALTH SYSTEM CONSOLIDATED WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10261021001
Policy instance 4
Insurance contract or identification number10261021001
Number of Individuals Covered102
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number681832G
Policy instance 3
Insurance contract or identification number681832G
Number of Individuals Covered8769
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $373,058
Total amount of fees paid to insurance companyUSD $138,494
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,996,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered10045
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $602,373
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 number0229054
Policy instance 1
Insurance contract or identification number0229054
Number of Individuals Covered12738
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $335,040
Total amount of fees paid to insurance companyUSD $70,682
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,161,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number681832G
Policy instance 3
Insurance contract or identification number681832G
Number of Individuals Covered17969
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $524,532
Total amount of fees paid to insurance companyUSD $124,218
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,885,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $398,814
Insurance broker organization code?3
Amount paid for insurance broker fees97630
Additional information about fees paid to insurance brokerSERVICE FEES
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered10435
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $440,418
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 number0229054
Policy instance 1
Insurance contract or identification number0229054
Number of Individuals Covered13075
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $368,373
Total amount of fees paid to insurance companyUSD $68,381
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,858,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $368,373
Amount paid for insurance broker fees68305
Additional information about fees paid to insurance brokerSUPPLEMENTAL AND NON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0229054
Policy instance 1
Insurance contract or identification number0229054
Number of Individuals Covered12794
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $231,486
Total amount of fees paid to insurance companyUSD $92
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,710,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $231,486
Amount paid for insurance broker fees54
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered10560
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $474,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number681832G
Policy instance 3
Insurance contract or identification number681832G
Number of Individuals Covered9133
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,069,710
Total amount of fees paid to insurance companyUSD $157,693
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,660,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $455,578
Amount paid for insurance broker fees76027
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS PAID
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804449G
Policy instance 3
Insurance contract or identification number804449G
Number of Individuals Covered5181
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $159,805
Total amount of fees paid to insurance companyUSD $79,467
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,152,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159,805
Insurance broker organization code?3
Amount paid for insurance broker fees79467
Additional information about fees paid to insurance brokerCONTINGENT FEES
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68498-8
Policy instance 2
Insurance contract or identification number68498-8
Number of Individuals Covered6984
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $324,149
Total amount of fees paid to insurance companyUSD $4,217
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,498,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $200,921
Insurance broker organization code?3
Amount paid for insurance broker fees4217
Additional information about fees paid to insurance brokerSERVICE FEE
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 1
Insurance contract or identification number9920257
Number of Individuals Covered8111
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $421,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804449G
Policy instance 4
Insurance contract or identification number804449G
Number of Individuals Covered5680
Insurance policy start date2019-08-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $58,491
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $777,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,491
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68498-8
Policy instance 3
Insurance contract or identification number68498-8
Number of Individuals Covered7089
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $372,601
Total amount of fees paid to insurance companyUSD $6,600
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,500,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $219,286
Additional information about fees paid to insurance brokerWRITING AGENT AND SUPP COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees6600
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered8599
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $498,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0283685-SHORT
Policy instance 1
Insurance contract or identification number0283685-SHORT
Number of Individuals Covered5646
Insurance policy start date2019-01-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $83,785
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,384,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83,785
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0283685
Policy instance 1
Insurance contract or identification number0283685
Number of Individuals Covered5042
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $269,572
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,062,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $269,572
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered7481
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68498-8
Policy instance 3
Insurance contract or identification number68498-8
Number of Individuals Covered11843
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $342,396
Total amount of fees paid to insurance companyUSD $6,783
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,175,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $195,659
Insurance broker organization code?3
Amount paid for insurance broker fees6783
Additional information about fees paid to insurance brokerSERVICE FEE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0283685
Policy instance 1
Insurance contract or identification number0283685
Number of Individuals Covered5083
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $90,977
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,045,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,977
Insurance broker organization code?3
Insurance broker nameVHA MID-AMERICA INSURANCE SERVICES
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )
Policy contract number9920257
Policy instance 2
Insurance contract or identification number9920257
Number of Individuals Covered7524
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $393,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker name
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68498-8
Policy instance 3
Insurance contract or identification number68498-8
Number of Individuals Covered9505
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $306,054
Total amount of fees paid to insurance companyUSD $6,783
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $878,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $161,189
Insurance broker organization code?3
Amount paid for insurance broker fees6783
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker nameBIGGIN CONSULTING SERVICES LLC
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 61360 )
Policy contract number68498-8
Policy instance 4
Insurance contract or identification number68498-8
Number of Individuals Covered2200
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $246,668
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $769,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $123,334
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010165408 00
Policy instance 1
Insurance contract or identification number000010165408 00
Number of Individuals Covered5147
Insurance policy start date2015-01-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $17,814
Total amount of fees paid to insurance companyUSD $10,000
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $356,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,814
Amount paid for insurance broker fees10000
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010144953 00
Policy instance 2
Insurance contract or identification number000010144953 00
Number of Individuals Covered4456
Insurance policy start date2015-10-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010144953 00
Policy instance 5
Insurance contract or identification number000010144953 00
Number of Individuals Covered4496
Insurance policy start date2015-01-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,542
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $357,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees8542
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000400001000 18
Policy instance 4
Insurance contract or identification number000400001000 18
Number of Individuals Covered3081
Insurance policy start date2015-01-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $87,774
Total amount of fees paid to insurance companyUSD $25,000
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $877,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $87,774
Amount paid for insurance broker fees25000
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0283685-SHORT
Policy instance 3
Insurance contract or identification number0283685-SHORT
Number of Individuals Covered10126
Insurance policy start date2015-12-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $107,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010165408 00
Policy instance 1
Insurance contract or identification number000010165408 00
Number of Individuals Covered4660
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $65,561
Total amount of fees paid to insurance companyUSD $22,500
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,311,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,561
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010144953 00
Policy instance 2
Insurance contract or identification number000010144953 00
Number of Individuals Covered3993
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $19,574
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $427,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees19574
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number000010165408 00
Policy instance 1
Insurance contract or identification number000010165408 00
Number of Individuals Covered4567
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $32,012
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,238,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,012
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number473231
Policy instance 1
Insurance contract or identification number473231
Number of Individuals Covered7003
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $127,517
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,280,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $127,517
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INSURANCE SERVICES
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number473231
Policy instance 1
Insurance contract or identification number473231
Number of Individuals Covered6313
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $130,748
Total amount of fees paid to insurance companyUSD $30,000
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,216,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number473231
Policy instance 1
Insurance contract or identification number473231
Number of Individuals Covered7070
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $96,635
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH-DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,155,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $96,635
Insurance broker organization code?3
Insurance broker nameVHA MID-AMERICA INSURANCE SERVICES

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