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R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 401k Plan overview

Plan NameR&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN
Plan identification number 504

R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

R&D SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:R&D SYSTEMS, INC.
Employer identification number (EIN):411280894
NAIC Classification:339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042021-07-01
5042020-07-01
5042019-07-01
5042018-07-01
5042017-07-01JENNIFER SCOTT
5042016-07-01JENNIFER SCOTT
5042015-07-01JENNIFER SCOTT
5042014-07-01JENNIFER SCOTT JENNIFER SCOTT2015-12-22
5042013-07-01JENNIFER SCOTT JENNIFER SCOTT2015-01-17
5042012-07-01JENNIFER SCOTT
5042011-07-01JENNIFER SCOTT
5042010-07-01JENNIFER SCOTT
5042009-07-01JENNIFER SCOTT

Plan Statistics for R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN

401k plan membership statisitcs for R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN

Measure Date Value
2021: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-011,633
Total number of active participants reported on line 7a of the Form 55002021-07-011,793
Number of retired or separated participants receiving benefits2021-07-0123
Total of all active and inactive participants2021-07-011,816
Total participants2021-07-011,816
2020: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-011,546
Total number of active participants reported on line 7a of the Form 55002020-07-011,618
Number of retired or separated participants receiving benefits2020-07-0115
Total of all active and inactive participants2020-07-011,633
Total participants2020-07-011,633
2019: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-011,495
Total number of active participants reported on line 7a of the Form 55002019-07-011,539
Number of retired or separated participants receiving benefits2019-07-017
Total of all active and inactive participants2019-07-011,546
Total participants2019-07-011,546
2018: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-011,207
Total number of active participants reported on line 7a of the Form 55002018-07-011,428
Number of retired or separated participants receiving benefits2018-07-015
Number of other retired or separated participants entitled to future benefits2018-07-0162
Total of all active and inactive participants2018-07-011,495
Total participants2018-07-011,495
2017: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-011,074
Total number of active participants reported on line 7a of the Form 55002017-07-011,178
Number of retired or separated participants receiving benefits2017-07-015
Number of other retired or separated participants entitled to future benefits2017-07-0124
Total of all active and inactive participants2017-07-011,207
Total participants2017-07-011,207
2016: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01995
Total number of active participants reported on line 7a of the Form 55002016-07-011,079
Number of retired or separated participants receiving benefits2016-07-014
Number of other retired or separated participants entitled to future benefits2016-07-0131
Total of all active and inactive participants2016-07-011,114
Total participants2016-07-011,114
2015: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01781
Total number of active participants reported on line 7a of the Form 55002015-07-01918
Number of retired or separated participants receiving benefits2015-07-018
Number of other retired or separated participants entitled to future benefits2015-07-0121
Total of all active and inactive participants2015-07-01947
Total participants2015-07-010
2014: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01648
Total number of active participants reported on line 7a of the Form 55002014-07-01648
Number of retired or separated participants receiving benefits2014-07-013
Number of other retired or separated participants entitled to future benefits2014-07-018
Total of all active and inactive participants2014-07-01659
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01659
2013: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01646
Total number of active participants reported on line 7a of the Form 55002013-07-01640
Number of retired or separated participants receiving benefits2013-07-012
Number of other retired or separated participants entitled to future benefits2013-07-014
Total of all active and inactive participants2013-07-01646
Total participants2013-07-01646
2012: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01642
Total number of active participants reported on line 7a of the Form 55002012-07-01646
Number of retired or separated participants receiving benefits2012-07-013
Number of other retired or separated participants entitled to future benefits2012-07-016
Total of all active and inactive participants2012-07-01655
Total participants2012-07-01655
2011: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01627
Total number of active participants reported on line 7a of the Form 55002011-07-01650
Number of retired or separated participants receiving benefits2011-07-015
Number of other retired or separated participants entitled to future benefits2011-07-014
Total of all active and inactive participants2011-07-01659
Total participants2011-07-01659
2010: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01615
Total number of active participants reported on line 7a of the Form 55002010-07-01619
Number of retired or separated participants receiving benefits2010-07-011
Number of other retired or separated participants entitled to future benefits2010-07-017
Total of all active and inactive participants2010-07-01627
Total participants2010-07-01627
2009: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01607
Total number of active participants reported on line 7a of the Form 55002009-07-01612
Number of retired or separated participants receiving benefits2009-07-013
Total of all active and inactive participants2009-07-01615
Total participants2009-07-01615

Form 5500 Responses for R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN

2021: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2010: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – General assets of the sponsorYes
2010-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: R&D SYSTEMS, INC. GROUP FAMILY MEDICAL PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number255899
Policy instance 2
Insurance contract or identification number255899
Number of Individuals Covered1649
Total amount of commissions paid to insurance brokerUSD $60,177
Total amount of fees paid to insurance companyUSD $50,700
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,183,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,177
Amount paid for insurance broker fees50700
Additional information about fees paid to insurance brokerBROKER INCENTIVE PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 1
Insurance contract or identification number603471
Number of Individuals Covered260
Total amount of commissions paid to insurance brokerUSD $71,644
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,296,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,644
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number234860
Policy instance 3
Insurance contract or identification number234860
Number of Individuals Covered38
Total amount of commissions paid to insurance brokerUSD $10,327
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,327
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number255899
Policy instance 2
Insurance contract or identification number255899
Number of Individuals Covered1512
Total amount of commissions paid to insurance brokerUSD $52,587
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,781,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,587
Additional information about fees paid to insurance brokerBROKER INCENTIVE PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 1
Insurance contract or identification number603471
Number of Individuals Covered243
Total amount of commissions paid to insurance brokerUSD $91,032
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,841,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91,032
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number255899
Policy instance 2
Insurance contract or identification number255899
Number of Individuals Covered1393
Total amount of commissions paid to insurance brokerUSD $48,861
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,703,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,861
Additional information about fees paid to insurance brokerBROKER INCENTIVE PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 1
Insurance contract or identification number603471
Number of Individuals Covered225
Total amount of commissions paid to insurance brokerUSD $74,835
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,492,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $74,835
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number255899
Policy instance 2
Insurance contract or identification number255899
Number of Individuals Covered1329
Total amount of commissions paid to insurance brokerUSD $47,457
Total amount of fees paid to insurance companyUSD $67,305
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,412,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,457
Amount paid for insurance broker fees67305
Additional information about fees paid to insurance brokerBROKER INCENTIVE PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 1
Insurance contract or identification number603471
Number of Individuals Covered210
Total amount of commissions paid to insurance brokerUSD $77,143
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,543,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $77,143
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 1
Insurance contract or identification number603471
Number of Individuals Covered175
Total amount of commissions paid to insurance brokerUSD $60,999
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,206,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,999
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number255899
Policy instance 2
Insurance contract or identification number255899
Number of Individuals Covered1253
Total amount of commissions paid to insurance brokerUSD $44,496
Total amount of fees paid to insurance companyUSD $67,305
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,139,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,496
Amount paid for insurance broker fees67305
Additional information about fees paid to insurance brokerBROKER INCENTIVE PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603471
Policy instance 2
Insurance contract or identification number603471
Number of Individuals Covered105
Total amount of commissions paid to insurance brokerUSD $67,164
Total amount of fees paid to insurance companyUSD $1,127
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $655,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered1073
Total amount of commissions paid to insurance brokerUSD $38,016
Total amount of fees paid to insurance companyUSD $29,784
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $885,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered918
Total amount of commissions paid to insurance brokerUSD $25,101
Total amount of fees paid to insurance companyUSD $4,162
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $471,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,101
Amount paid for insurance broker fees3596
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM CALENDAR YEAR 2015
Insurance broker organization code?3
Insurance broker nameAIM HEALTHCARE SERVICES
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered1581
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $26,033
Total amount of fees paid to insurance companyUSD $480,934
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,168,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,139
Amount paid for insurance broker fees2894
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM CALENDAR YEAR 2014
Insurance broker organization code?3
Insurance broker nameCHRISTENSEN GROUP
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered1522
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $26,177
Total amount of fees paid to insurance companyUSD $389,156
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,019,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,274
Amount paid for insurance broker fees2903
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
Insurance broker nameDONALD B SCHREIFELS & ASSOCIATES
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered646
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $26,082
Total amount of fees paid to insurance companyUSD $380,966
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $996,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,082
Amount paid for insurance broker fees2889
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
Insurance broker nameDON SCHREIFELS & ASSOC.
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract numberMULTIPLE
Policy instance 1
Insurance contract or identification numberMULTIPLE
Number of Individuals Covered650
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $36,009
Total amount of fees paid to insurance companyUSD $326,538
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $893,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number142892
Policy instance 1
Insurance contract or identification number142892
Number of Individuals Covered620
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $27,037
Total amount of fees paid to insurance companyUSD $280,099
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $760,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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