NU WAY CONCRETE FORMS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN
Measure | Date | Value |
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2022: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 346 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 380 |
Total of all active and inactive participants | 2022-01-01 | 380 |
2021: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 362 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 346 |
Total of all active and inactive participants | 2021-01-01 | 346 |
2020: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 381 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 362 |
Total of all active and inactive participants | 2020-01-01 | 362 |
2019: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 386 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 381 |
Total of all active and inactive participants | 2019-01-01 | 381 |
2018: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 385 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 386 |
Total of all active and inactive participants | 2018-01-01 | 386 |
2017: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 406 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 385 |
Total of all active and inactive participants | 2017-01-01 | 385 |
2016: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 380 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 406 |
Total of all active and inactive participants | 2016-01-01 | 406 |
2015: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 327 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 380 |
Total of all active and inactive participants | 2015-01-01 | 380 |
Total participants | 2015-01-01 | 0 |
2014: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 308 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 327 |
Total of all active and inactive participants | 2014-01-01 | 327 |
Total participants | 2014-01-01 | 0 |
2013: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 322 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 308 |
Total of all active and inactive participants | 2013-01-01 | 308 |
Total participants | 2013-01-01 | 0 |
2012: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 375 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 322 |
Total of all active and inactive participants | 2012-01-01 | 322 |
Total participants | 2012-01-01 | 0 |
2011: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 332 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 375 |
Total of all active and inactive participants | 2011-01-01 | 375 |
Total participants | 2011-01-01 | 375 |
2022: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | Yes |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: NU WAY CONCRETE FORMS, INC GROUPHEALTH PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 44 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $155 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,034 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $155 | Insurance broker organization code? | 4 |
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MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 011858 |
Policy instance | 1 |
Insurance contract or identification number | 011858 | Number of Individuals Covered | 201 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $21,956 | Total amount of fees paid to insurance company | USD $7,801 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $159,209 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,956 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 7801 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00511282 |
Policy instance | 2 |
Insurance contract or identification number | 00511282 | Number of Individuals Covered | 195 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $6,743 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,743 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 1 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 57 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $308 | Total amount of fees paid to insurance company | USD $4 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,907 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $308 | Amount paid for insurance broker fees | 4 | Insurance broker organization code? | 4 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00511282 |
Policy instance | 2 |
Insurance contract or identification number | 00511282 | Number of Individuals Covered | 180 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $7,133 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $90,484 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,133 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 1 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 62 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $335 | Total amount of fees paid to insurance company | USD $3 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $335 | Amount paid for insurance broker fees | 3 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 4 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 0006F342 |
Policy instance | 2 |
Insurance contract or identification number | 0006F342 | Number of Individuals Covered | 189 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $7,017 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84,005 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,017 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 1 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 68 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $449 | Total amount of fees paid to insurance company | USD $9 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,719 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $449 | Amount paid for insurance broker fees | 9 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 4 | Are there contracts with allocated funds for individual policies? | 0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 1 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 72 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $562 | Total amount of fees paid to insurance company | USD $19 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $562 | Amount paid for insurance broker fees | 19 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 4 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 0006F342 |
Policy instance | 2 |
Insurance contract or identification number | 0006F342 | Number of Individuals Covered | 184 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $7,006 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,243 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,006 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 0006F342 |
Policy instance | 3 |
Insurance contract or identification number | 0006F342 | Number of Individuals Covered | 184 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $6,977 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,977 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,977 | Insurance broker organization code? | 3 | Insurance broker name | GARY R BECKS |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 79 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $750 | Total amount of fees paid to insurance company | USD $25 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,312 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $750 | Amount paid for insurance broker fees | 25 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 4 | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL31576 |
Policy instance | 1 |
Insurance contract or identification number | HCL31576 | Number of Individuals Covered | 73 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $11,447 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $209,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,447 | Insurance broker organization code? | 5 | Insurance broker name | HEALTHSCOPE BENEFITS, INC. |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 89 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $835 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,080 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $835 | Insurance broker organization code? | 4 | Insurance broker name | JW TERRILL SERVICES, INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00511282 |
Policy instance | 3 |
Insurance contract or identification number | 00511282 | Number of Individuals Covered | 171 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of fees paid to insurance company | USD $6,375 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,201 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6375 | Insurance broker organization code? | 3 | Insurance broker name | GARY R BECKS |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 1 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 146 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $314,439 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 1 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 140 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $282,385 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 109 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $2,086 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,086 | Insurance broker organization code? | 4 | Insurance broker name | JW TERRILL SERVICES, INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ACJH |
Policy instance | 3 |
Insurance contract or identification number | G000ACJH | Number of Individuals Covered | 164 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-03-01 | Total amount of commissions paid to insurance broker | USD $7,065 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,065 | Insurance broker organization code? | 3 | Insurance broker name | GARY R BECKS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ACJH |
Policy instance | 3 |
Insurance contract or identification number | G000ACJH | Number of Individuals Covered | 150 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-03-01 | Total amount of commissions paid to insurance broker | USD $7,031 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,031 | Insurance broker organization code? | 3 | Insurance broker name | GARY R BECKS |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 114 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,090 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $25,168 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,090 | Insurance broker organization code? | 4 | Insurance broker name | JW TERRILL SERVICES, INC |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 1 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 128 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $286,244 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ACJH |
Policy instance | 1 |
Insurance contract or identification number | G000ACJH | Number of Individuals Covered | 149 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-03-01 | Total amount of commissions paid to insurance broker | USD $6,257 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,257 | Insurance broker name | GARY R BECKS |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 3 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 128 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $314,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 60 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $744 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $744 | Insurance broker organization code? | 4 | Insurance broker name | JW TERRILL SERVICES, INC |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 3 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 350 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $296,807 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ACJH |
Policy instance | 1 |
Insurance contract or identification number | G000ACJH | Number of Individuals Covered | 148 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-03-01 | Total amount of commissions paid to insurance broker | USD $5,719 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 2 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 72 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2012-01-01 | Total amount of commissions paid to insurance broker | USD $1,409 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHSCOPE BENEFITS, INC (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | 314-768-7309 |
Policy instance | 2 |
Insurance contract or identification number | 314-768-7309 | Number of Individuals Covered | 350 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $316,512 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008461086 |
Policy instance | 1 |
Insurance contract or identification number | 0008461086 | Number of Individuals Covered | 67 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $800 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,262 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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