HENGESTONE HOLDINGS, INC. has sponsored the creation of one or more 401k plans.
Additional information about HENGESTONE HOLDINGS, INC.
Submission information for form 5500 for 401k plan UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN
401k plan membership statisitcs for UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN
| Measure | Date | Value |
|---|
| 2021: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-11-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-11-01 | 171 |
| Total of all active and inactive participants | 2021-11-01 | 171 |
| 2020: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-11-01 | 151 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 152 |
| Total of all active and inactive participants | 2020-11-01 | 152 |
| 2019: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-11-01 | 165 |
| Number of retired or separated participants receiving benefits | 2019-11-01 | 151 |
| Total of all active and inactive participants | 2019-11-01 | 151 |
| 2018: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 164 |
| Number of retired or separated participants receiving benefits | 2018-11-01 | 1 |
| Total of all active and inactive participants | 2018-11-01 | 165 |
| 2017: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 142 |
| Total of all active and inactive participants | 2017-11-01 | 142 |
| 2016: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 135 |
| Total of all active and inactive participants | 2016-11-01 | 135 |
| 2015: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 132 |
| Total of all active and inactive participants | 2015-11-01 | 132 |
| 2014: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 109 |
| Number of retired or separated participants receiving benefits | 2014-11-01 | 1 |
| Total of all active and inactive participants | 2014-11-01 | 110 |
| 2013: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 105 |
| Total of all active and inactive participants | 2013-11-01 | 105 |
| 2012: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 111 |
| Number of retired or separated participants receiving benefits | 2012-11-01 | 1 |
| Total of all active and inactive participants | 2012-11-01 | 112 |
| 2011: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 107 |
| Number of retired or separated participants receiving benefits | 2011-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-11-01 | 0 |
| Total of all active and inactive participants | 2011-11-01 | 107 |
| 2009: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 94 |
| Number of retired or separated participants receiving benefits | 2009-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-11-01 | 0 |
| Total of all active and inactive participants | 2009-11-01 | 94 |
| 2008: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-11-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-11-01 | 112 |
| Number of retired or separated participants receiving benefits | 2008-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-11-01 | 0 |
| Total of all active and inactive participants | 2008-11-01 | 112 |
| 2007: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-11-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-11-01 | 138 |
| Number of retired or separated participants receiving benefits | 2007-11-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2007-11-01 | 0 |
| Total of all active and inactive participants | 2007-11-01 | 139 |
| 2021: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2021 form 5500 responses |
|---|
| 2021-11-01 | Type of plan entity | Single employer plan |
| 2021-11-01 | Plan funding arrangement – Insurance | Yes |
| 2021-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2020 form 5500 responses |
|---|
| 2020-11-01 | Type of plan entity | Single employer plan |
| 2020-11-01 | Plan funding arrangement – Insurance | Yes |
| 2020-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2019 form 5500 responses |
|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Plan funding arrangement – Insurance | Yes |
| 2019-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2018 form 5500 responses |
|---|
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2017 form 5500 responses |
|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2016 form 5500 responses |
|---|
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2015 form 5500 responses |
|---|
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2014 form 5500 responses |
|---|
| 2014-11-01 | Type of plan entity | Single employer plan |
| 2014-11-01 | Plan funding arrangement – Insurance | Yes |
| 2014-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2013 form 5500 responses |
|---|
| 2013-11-01 | Type of plan entity | Single employer plan |
| 2013-11-01 | Plan funding arrangement – Insurance | Yes |
| 2013-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2012 form 5500 responses |
|---|
| 2012-11-01 | Type of plan entity | Single employer plan |
| 2012-11-01 | Plan funding arrangement – Insurance | Yes |
| 2012-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2011 form 5500 responses |
|---|
| 2011-11-01 | Type of plan entity | Single employer plan |
| 2011-11-01 | Plan funding arrangement – Insurance | Yes |
| 2011-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2009 form 5500 responses |
|---|
| 2009-11-01 | Type of plan entity | Single employer plan |
| 2009-11-01 | This submission is the final filing | No |
| 2009-11-01 | Plan funding arrangement – Insurance | Yes |
| 2009-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2008 form 5500 responses |
|---|
| 2008-11-01 | Type of plan entity | Single employer plan |
| 2008-11-01 | Plan funding arrangement – Insurance | Yes |
| 2008-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: UNILOCK CHICAGO, INC. MEDICAL AND VISION PLAN 2007 form 5500 responses |
|---|
| 2007-11-01 | Type of plan entity | Single employer plan |
| 2007-11-01 | First time form 5500 has been submitted | Yes |
| 2007-11-01 | Plan funding arrangement – Insurance | Yes |
| 2007-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 97657101001 |
| Policy instance | 2 |
| Insurance contract or identification number | 97657101001 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $1,592 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,058 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,592 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B/P68655,PA3961 |
| Policy instance | 1 |
| Insurance contract or identification number | B/P68655,PA3961 | | Number of Individuals Covered | 383 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $98,276 | | Total amount of fees paid to insurance company | USD $3,825 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,328,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $98,276 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3825 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B/P68655,PA3961 |
| Policy instance | 1 |
| Insurance contract or identification number | B/P68655,PA3961 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $73,549 | | Total amount of fees paid to insurance company | USD $3,750 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,924,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $59,843 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3750 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 97657101001 |
| Policy instance | 2 |
| Insurance contract or identification number | 97657101001 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $1,775 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,299 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 97657101001 |
| Policy instance | 2 |
| Insurance contract or identification number | 97657101001 | | Number of Individuals Covered | 368 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $1,448 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,432 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,448 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B/P68655,PA3961 |
| Policy instance | 1 |
| Insurance contract or identification number | B/P68655,PA3961 | | Number of Individuals Covered | 375 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $71,169 | | Total amount of fees paid to insurance company | USD $4,000 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,834,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,169 | | Amount paid for insurance broker fees | 4000 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 97657101001 |
| Policy instance | 2 |
| Insurance contract or identification number | 97657101001 | | Number of Individuals Covered | 400 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $1,540 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,540 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B/P68655,PA3961 |
| Policy instance | 1 |
| Insurance contract or identification number | B/P68655,PA3961 | | Number of Individuals Covered | 375 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $73,558 | | Total amount of fees paid to insurance company | USD $3,625 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,901,635 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $73,558 | | Amount paid for insurance broker fees | 3625 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B/P68655,PA3961 |
| Policy instance | 1 |
| Insurance contract or identification number | B/P68655,PA3961 | | Number of Individuals Covered | 374 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $70,743 | | Total amount of fees paid to insurance company | USD $3,100 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,857,312 | | 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 number | 97657101001 |
| Policy instance | 2 |
| Insurance contract or identification number | 97657101001 | | Number of Individuals Covered | 290 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $1,201 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,145 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B68655 P68655 |
| Policy instance | 1 |
| Insurance contract or identification number | B68655 P68655 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $45,404 | | Total amount of fees paid to insurance company | USD $2,180 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,165,084 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,404 | | Amount paid for insurance broker fees | 2180 | | Insurance broker organization code? | 3 | | Insurance broker name | VISTANATIONAL INSURANCE AGENCY |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B68655 P68655 |
| Policy instance | 1 |
| Insurance contract or identification number | B68655 P68655 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $43,673 | | Total amount of fees paid to insurance company | USD $1,193 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,118,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,673 | | Amount paid for insurance broker fees | 1193 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 | | Insurance broker name | VISTA NATIONAL INSURANCE GROUP, INC |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B68655 P68655 |
| Policy instance | 1 |
| Insurance contract or identification number | B68655 P68655 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $41,243 | | Total amount of fees paid to insurance company | USD $1,380 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,034,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,243 | | Amount paid for insurance broker fees | 1380 | | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | | Insurance broker organization code? | 3 | | Insurance broker name | VISTANATIONAL INSURANCE GROUP, INC. |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B68655 P68655 |
| Policy instance | 1 |
| Insurance contract or identification number | B68655 P68655 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $41,120 | | 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 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $989,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0717733 |
| Policy instance | 1 |
| Insurance contract or identification number | 0717733 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $40,236 | | 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 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $752,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 528757 |
| Policy instance | 1 |
| Insurance contract or identification number | 528757 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2008-11-01 | | Insurance policy end date | 2009-10-31 | | Total amount of commissions paid to insurance broker | USD $20,272 | | 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 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $404,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,732 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 588 | | Additional information about fees paid to insurance broker | TPA PARTNERSHIP PROGRAM |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B21571 P21571 |
| Policy instance | 1 |
| Insurance contract or identification number | B21571 P21571 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2007-11-01 | | Insurance policy end date | 2008-10-31 | | Total amount of commissions paid to insurance broker | USD $28,681 | | 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 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $843,114 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
