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RIDGECREST VILLAGE 401k Plan overview

Plan NameRIDGECREST VILLAGE
Plan identification number 501

RIDGECREST VILLAGE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CHRISTIAN RETIREMENT HOMES INC has sponsored the creation of one or more 401k plans.

Company Name:CHRISTIAN RETIREMENT HOMES INC
Employer identification number (EIN):420897875
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about CHRISTIAN RETIREMENT HOMES INC

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1963-10-29
Company Identification Number: 055873
Legal Registered Office Address: 4130 NORTHWEST BLVD

DAVENPORT
United States of America (USA)
52806

More information about CHRISTIAN RETIREMENT HOMES INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIDGECREST VILLAGE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01
5012022-04-01
5012021-04-01
5012020-04-01
5012020-01-01
5012019-04-01
5012019-01-01
5012018-04-01
5012018-01-01STEPHANIE ARP
5012017-04-01STEPHANIE ARP
5012017-01-01STEPHANIE ARP
5012016-01-01STEPHANIE ARP
5012015-01-01STEPHANIE ARP
5012014-01-01BERT VIGEN
5012013-01-01BERT VIGEN
5012011-04-01KIRK JOHNSON KIRK JOHNSON2012-05-17
5012009-01-01 KIRK JOHNSON2010-10-06
5012009-01-01KIRK JOHNSON

Plan Statistics for RIDGECREST VILLAGE

401k plan membership statisitcs for RIDGECREST VILLAGE

Measure Date Value
2023: RIDGECREST VILLAGE 2023 401k membership
Total participants, beginning-of-year2023-04-0165
Total number of active participants reported on line 7a of the Form 55002023-04-0172
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-0172
2022: RIDGECREST VILLAGE 2022 401k membership
Total participants, beginning-of-year2022-04-0176
Total number of active participants reported on line 7a of the Form 55002022-04-0165
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-0165
2021: RIDGECREST VILLAGE 2021 401k membership
Total participants, beginning-of-year2021-04-0193
Total number of active participants reported on line 7a of the Form 55002021-04-0176
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-0176
2020: RIDGECREST VILLAGE 2020 401k membership
Total participants, beginning-of-year2020-04-01104
Total number of active participants reported on line 7a of the Form 55002020-04-0193
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-0193
Total participants, beginning-of-year2020-01-01151
Total number of active participants reported on line 7a of the Form 55002020-01-01133
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01133
2019: RIDGECREST VILLAGE 2019 401k membership
Total participants, beginning-of-year2019-04-01109
Total number of active participants reported on line 7a of the Form 55002019-04-01104
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01104
Total participants, beginning-of-year2019-01-01145
Total number of active participants reported on line 7a of the Form 55002019-01-01151
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01151
2018: RIDGECREST VILLAGE 2018 401k membership
Total participants, beginning-of-year2018-04-01112
Total number of active participants reported on line 7a of the Form 55002018-04-01109
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01109
Total participants, beginning-of-year2018-01-01160
Total number of active participants reported on line 7a of the Form 55002018-01-01145
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01145
2017: RIDGECREST VILLAGE 2017 401k membership
Total participants, beginning-of-year2017-04-01108
Total number of active participants reported on line 7a of the Form 55002017-04-01112
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01112
Total participants, beginning-of-year2017-01-01152
Total number of active participants reported on line 7a of the Form 55002017-01-01160
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01160
2016: RIDGECREST VILLAGE 2016 401k membership
Total participants, beginning-of-year2016-01-01156
Total number of active participants reported on line 7a of the Form 55002016-01-01152
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01152
2015: RIDGECREST VILLAGE 2015 401k membership
Total participants, beginning-of-year2015-01-01154
Total number of active participants reported on line 7a of the Form 55002015-01-01156
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01156
2014: RIDGECREST VILLAGE 2014 401k membership
Total participants, beginning-of-year2014-01-01139
Total number of active participants reported on line 7a of the Form 55002014-01-01154
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01154
2013: RIDGECREST VILLAGE 2013 401k membership
Total participants, beginning-of-year2013-01-010
Total number of active participants reported on line 7a of the Form 55002013-01-01139
Total of all active and inactive participants2013-01-01139
2011: RIDGECREST VILLAGE 2011 401k membership
Total participants, beginning-of-year2011-04-01146
Total number of active participants reported on line 7a of the Form 55002011-04-01145
Total of all active and inactive participants2011-04-01145
Total participants2011-04-01145
2009: RIDGECREST VILLAGE 2009 401k membership
Total participants, beginning-of-year2009-01-01146
Total number of active participants reported on line 7a of the Form 55002009-01-01133
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01133
Total participants2009-01-01133

Form 5500 Responses for RIDGECREST VILLAGE

2023: RIDGECREST VILLAGE 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: RIDGECREST VILLAGE 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: RIDGECREST VILLAGE 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: RIDGECREST VILLAGE 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: RIDGECREST VILLAGE 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: RIDGECREST VILLAGE 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: RIDGECREST VILLAGE 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01First time form 5500 has been submittedYes
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: RIDGECREST VILLAGE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: RIDGECREST VILLAGE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: RIDGECREST VILLAGE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: RIDGECREST VILLAGE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2011: RIDGECREST VILLAGE 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2009: RIDGECREST VILLAGE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered60
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Total amount of commissions paid to insurance brokerUSD $19,488
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered72
Insurance policy start date2023-04-01
Insurance policy end date2024-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered53
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $14,910
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,910
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered65
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered65
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $17,220
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,220
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered76
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered93
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered83
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $19,872
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,872
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered133
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,143
Total amount of fees paid to insurance companyUSD $127
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $736
Additional information about fees paid to insurance brokerSALES COMMISSION
Insurance broker organization code?3
Amount paid for insurance broker fees127
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered97
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $21,636
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,636
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered104
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered151
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $1,203
Total amount of fees paid to insurance companyUSD $252
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,203
Additional information about fees paid to insurance brokerSALES COMMISION
Insurance broker organization code?3
Amount paid for insurance broker fees252
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered103
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $22,158
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,158
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered109
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL (National Association of Insurance Commissioners NAIC id number: 85090 )
Policy contract numberM250000020
Policy instance 2
Insurance contract or identification numberM250000020
Number of Individuals Covered145
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered145
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $1,214
Total amount of fees paid to insurance companyUSD $135
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,214
Additional information about fees paid to insurance brokerSALES COMMISION
Insurance broker organization code?3
Amount paid for insurance broker fees135
WELLMARK HEALTH PLAN OF IOWA (National Association of Insurance Commissioners NAIC id number: 95531 )
Policy contract number095
Policy instance 2
Insurance contract or identification number095
Number of Individuals Covered95
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $22,572
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,572
Additional information about fees paid to insurance brokerINDIRECT COMMISSIONS ALLOCATION
Insurance broker organization code?3
Insurance broker nameMOLYNEAUX INSURANCE
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number33418
Policy instance 1
Insurance contract or identification number33418
Number of Individuals Covered112
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered160
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $1,245
Total amount of fees paid to insurance companyUSD $138
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,245
Additional information about fees paid to insurance brokerSALES COMMISION
Insurance broker organization code?3
Amount paid for insurance broker fees138
Insurance broker nameWELLMARK INC
DEARBORN NATIONAL (National Association of Insurance Commissioners NAIC id number: 85090 )
Policy contract numberM250000020
Policy instance 2
Insurance contract or identification numberM250000020
Number of Individuals Covered160
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL (National Association of Insurance Commissioners NAIC id number: 85090 )
Policy contract numberM250000020
Policy instance 2
Insurance contract or identification numberM250000020
Number of Individuals Covered156
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered156
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $1,291
Total amount of fees paid to insurance companyUSD $143
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees143
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,291
Insurance broker nameLAMAIR MULOCK CONDON COMPANY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered154
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,313
Total amount of fees paid to insurance companyUSD $146
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees146
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,313
Insurance broker nameLAMAIR MULOCK CONDON COMPANY
DEARBORN NATIONAL (National Association of Insurance Commissioners NAIC id number: 85090 )
Policy contract numberM250000020
Policy instance 2
Insurance contract or identification numberM250000020
Number of Individuals Covered154
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL (National Association of Insurance Commissioners NAIC id number: 85090 )
Policy contract numberM250000020
Policy instance 2
Insurance contract or identification numberM250000020
Number of Individuals Covered139
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberM250000020
Policy instance 1
Insurance contract or identification numberM250000020
Number of Individuals Covered139
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,269
Total amount of fees paid to insurance companyUSD $92
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $452
Amount paid for insurance broker fees92
Insurance broker organization code?3
Insurance broker nameLAMAIR MULOCK CONDON COMPANY
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number90027
Policy instance 1
Insurance contract or identification number90027
Number of Individuals Covered145
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number20
Policy instance 2
Insurance contract or identification number20
Number of Individuals Covered150
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,387
Total amount of fees paid to insurance companyUSD $1,387
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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