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GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan NameGROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN
Plan identification number 501

GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

GROUP HEALTH PLAN, INC. has sponsored the creation of one or more 401k plans.

Company Name:GROUP HEALTH PLAN, INC.
Employer identification number (EIN):410797853
NAIC Classification:621491
NAIC Description:HMO Medical Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01ANAHITA CAMERON ANAHITA CAMERON2019-06-29
5012017-01-01ANAHITA CAMERON2018-10-10 ANAHITA CAMERON2018-10-10
5012016-01-01CALVIN ALLEN2017-07-17 CALVIN ALLEN2017-07-17
5012015-01-01CALVIN ALLEN2016-10-14 CALVIN ALLEN2016-10-14
5012014-01-01CALVIN ALLEN2015-10-15 CALVIN ALLEN2015-10-15
5012013-01-01CALVIN ALLEN2014-07-23 CALVIN ALLEN2014-07-23
5012012-01-01CALVIN ALLEN2013-10-07 CALVIN ALLEN2013-10-07
5012011-01-01CALVIN ALLEN2012-09-30 CALVIN ALLEN2012-09-30
5012010-01-01CALVIN ALLEN2011-07-21 CALVIN ALLEN2011-07-21
5012009-01-01CALVIN ALLEN2010-10-13 CALVIN ALLEN2010-10-13

Plan Statistics for GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN

Measure Date Value
2022: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017,311
Total number of active participants reported on line 7a of the Form 55002022-01-017,316
Number of retired or separated participants receiving benefits2022-01-0196
Total of all active and inactive participants2022-01-017,412
2021: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-016,994
Total number of active participants reported on line 7a of the Form 55002021-01-017,095
Number of retired or separated participants receiving benefits2021-01-01133
Total of all active and inactive participants2021-01-017,228
2020: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-017,084
Total number of active participants reported on line 7a of the Form 55002020-01-016,547
Number of retired or separated participants receiving benefits2020-01-01214
Total of all active and inactive participants2020-01-016,761
2019: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-017,321
Total number of active participants reported on line 7a of the Form 55002019-01-017,084
Number of retired or separated participants receiving benefits2019-01-01185
Total of all active and inactive participants2019-01-017,269
2018: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-016,990
Total number of active participants reported on line 7a of the Form 55002018-01-016,858
Number of retired or separated participants receiving benefits2018-01-01105
Total of all active and inactive participants2018-01-016,963
2017: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-016,424
Total number of active participants reported on line 7a of the Form 55002017-01-016,424
Number of retired or separated participants receiving benefits2017-01-01106
Total of all active and inactive participants2017-01-016,530
2016: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-016,209
Total number of active participants reported on line 7a of the Form 55002016-01-016,424
Number of retired or separated participants receiving benefits2016-01-01132
Total of all active and inactive participants2016-01-016,556
2015: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-016,054
Total number of active participants reported on line 7a of the Form 55002015-01-016,209
Number of retired or separated participants receiving benefits2015-01-01310
Total of all active and inactive participants2015-01-016,519
2014: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-016,258
Total number of active participants reported on line 7a of the Form 55002014-01-015,951
Number of retired or separated participants receiving benefits2014-01-01103
Total of all active and inactive participants2014-01-016,054
2013: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-015,351
Total number of active participants reported on line 7a of the Form 55002013-01-015,577
Number of retired or separated participants receiving benefits2013-01-0182
Total of all active and inactive participants2013-01-015,659
2012: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015,679
Total number of active participants reported on line 7a of the Form 55002012-01-015,261
Number of retired or separated participants receiving benefits2012-01-0190
Total of all active and inactive participants2012-01-015,351
2011: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015,492
Total number of active participants reported on line 7a of the Form 55002011-01-015,577
Number of retired or separated participants receiving benefits2011-01-01102
Total of all active and inactive participants2011-01-015,679
2010: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-015,470
Total number of active participants reported on line 7a of the Form 55002010-01-015,382
Number of retired or separated participants receiving benefits2010-01-01110
Total of all active and inactive participants2010-01-015,492
2009: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-015,409
Total number of active participants reported on line 7a of the Form 55002009-01-015,338
Number of retired or separated participants receiving benefits2009-01-01132
Total of all active and inactive participants2009-01-015,470

Form 5500 Responses for GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN

2022: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. 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: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP HEALTH PLAN, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6185
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
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,611,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered6306
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 $58,994
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,637,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees58994
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered7034
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 $4,076
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4076
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered5872
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
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,435,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered6008
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 $57,635
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,564,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees57635
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered6229
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 $3,996
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3996
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered6548
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,096
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $181,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,096
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered5842
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 $56,783
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,521,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees56783
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6040
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 $17,258
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,076,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees17258
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6559
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 $10,081
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,307,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered6179
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 $56,706
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,520,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees56706
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered7066
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 $4,375
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $194,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4375
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6789
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 $13,516
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,970,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13516
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered6272
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 $55,834
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,954,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees55834
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered33817
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 $4,399
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $192,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4399
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6287
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 $14,203
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,866,538
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 fees14203
Additional information about fees paid to insurance brokerSUPPLEMENTAL FEES
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered6005
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 $66,229
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,954,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees66229
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered6989
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 $4,137
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,556
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 fees4137
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered6511
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,877
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,680
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 fees3877
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered5631
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $59,812
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,679,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees59812
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $0
Insurance broker nameTOWERS WATSON DELAWARE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered6031
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,965,912
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 fees0
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK980057
Policy instance 3
Insurance contract or identification numberFLK980057
Number of Individuals Covered5268
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $50,000
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
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,165,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,000
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 2
Insurance contract or identification number33817
Number of Individuals Covered5207
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $47,100
Total amount of fees paid to insurance companyUSD $58,169
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,591,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees58169
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $47,100
Insurance broker nameTOWERS WATSON DELAWARE INC
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number33817
Policy instance 1
Insurance contract or identification number33817
Number of Individuals Covered5759
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,900
Total amount of fees paid to insurance companyUSD $3,582
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3582
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $2,900
Insurance broker nameTOWERS WATSON DELAWARE INC

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