AUTO TIRE & PARTS COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AUTO TIRE & PARTS CO INC HEALTH PLAN
Measure | Date | Value |
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2022: AUTO TIRE & PARTS CO INC HEALTH PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 153 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 160 |
Total of all active and inactive participants | 2022-01-01 | 160 |
2021: AUTO TIRE & PARTS CO INC HEALTH PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 162 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 153 |
Total of all active and inactive participants | 2021-01-01 | 153 |
2020: AUTO TIRE & PARTS CO INC HEALTH PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 162 |
Total of all active and inactive participants | 2020-01-01 | 162 |
2019: AUTO TIRE & PARTS CO INC HEALTH PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 148 |
Total of all active and inactive participants | 2019-01-01 | 148 |
2018: AUTO TIRE & PARTS CO INC HEALTH PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 159 |
Total of all active and inactive participants | 2018-01-01 | 159 |
2017: AUTO TIRE & PARTS CO INC HEALTH PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 159 |
Total of all active and inactive participants | 2017-01-01 | 159 |
2016: AUTO TIRE & PARTS CO INC HEALTH PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 144 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 148 |
Total of all active and inactive participants | 2016-01-01 | 148 |
2015: AUTO TIRE & PARTS CO INC HEALTH PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 149 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 144 |
Total of all active and inactive participants | 2015-01-01 | 144 |
2014: AUTO TIRE & PARTS CO INC HEALTH PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 149 |
Total of all active and inactive participants | 2014-01-01 | 149 |
Total participants | 2014-01-01 | 149 |
2013: AUTO TIRE & PARTS CO INC HEALTH PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 149 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 142 |
Total of all active and inactive participants | 2013-01-01 | 142 |
Total participants | 2013-01-01 | 142 |
2012: AUTO TIRE & PARTS CO INC HEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 149 |
Total of all active and inactive participants | 2012-01-01 | 149 |
Total participants | 2012-01-01 | 149 |
2011: AUTO TIRE & PARTS CO INC HEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 140 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 148 |
Total of all active and inactive participants | 2011-01-01 | 148 |
Total participants | 2011-01-01 | 148 |
2010: AUTO TIRE & PARTS CO INC HEALTH PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 171 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 140 |
Total of all active and inactive participants | 2010-01-01 | 140 |
Total participants | 2010-01-01 | 140 |
2022: AUTO TIRE & PARTS CO INC HEALTH PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
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: AUTO TIRE & PARTS CO INC HEALTH 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: AUTO TIRE & PARTS CO INC HEALTH 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: AUTO TIRE & PARTS CO INC HEALTH 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: AUTO TIRE & PARTS CO INC HEALTH 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: AUTO TIRE & PARTS CO INC HEALTH 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: AUTO TIRE & PARTS CO INC HEALTH 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 |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: AUTO TIRE & PARTS CO INC HEALTH 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 |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: AUTO TIRE & PARTS CO INC HEALTH 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 |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: AUTO TIRE & PARTS CO INC HEALTH PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Mulitple employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: AUTO TIRE & PARTS CO INC HEALTH PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Mulitple employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: AUTO TIRE & PARTS CO INC HEALTH PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Mulitple employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2010: AUTO TIRE & PARTS CO INC HEALTH PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Mulitple employer plan |
2010-01-01 | First time form 5500 has been submitted | Yes |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E5754684 |
Policy instance | 3 |
Insurance contract or identification number | E5754684 | Number of Individuals Covered | 28 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,533 | Total amount of fees paid to insurance company | USD $1,941 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER | Welfare Benefit Premiums Paid to Carrier | USD $19,567 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,882 | Amount paid for insurance broker fees | 487 | Insurance broker organization code? | 3 |
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RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 ) |
Policy contract number | 80522 |
Policy instance | 2 |
Insurance contract or identification number | 80522 | Number of Individuals Covered | 439 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $26,683 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | 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 $161,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,683 | Insurance broker organization code? | 3 |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
Policy contract number | LGS02625-22 |
Policy instance | 1 |
Insurance contract or identification number | LGS02625-22 | Number of Individuals Covered | 160 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $47,700 | Total amount of fees paid to insurance company | USD $101,514 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $315,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 87013 | Additional information about fees paid to insurance broker | PROGRAM FEES | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $47,700 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1001004 |
Policy instance | 1 |
Insurance contract or identification number | 1001004 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $1,359 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | MANAGED TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $13,595 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,359 | Insurance broker organization code? | 5 |
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KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
Policy contract number | 65129 |
Policy instance | 2 |
Insurance contract or identification number | 65129 | Number of Individuals Covered | 137 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,593 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,025 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,593 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 925217 |
Policy instance | 3 |
Insurance contract or identification number | 925217 | Number of Individuals Covered | 130 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $12,094 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $72,191 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,094 | Insurance broker organization code? | 3 |
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AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
Policy contract number | AN-2012001 |
Policy instance | 4 |
Insurance contract or identification number | AN-2012001 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $352,679 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
Policy contract number | LGS02625-21 |
Policy instance | 5 |
Insurance contract or identification number | LGS02625-21 | Number of Individuals Covered | 153 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,825 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $39,759 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,825 | Insurance broker organization code? | 3 |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 1 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $309,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1001004 |
Policy instance | 2 |
Insurance contract or identification number | 1001004 | Number of Individuals Covered | 162 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,547 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | MANAGED TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $15,433 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,547 | Insurance broker organization code? | 5 |
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KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
Policy contract number | 65129 |
Policy instance | 3 |
Insurance contract or identification number | 65129 | Number of Individuals Covered | 152 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,615 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,615 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 925217 |
Policy instance | 4 |
Insurance contract or identification number | 925217 | Number of Individuals Covered | 129 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $6,248 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,248 | Insurance broker organization code? | 3 |
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AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
Policy contract number | AN-2012001 |
Policy instance | 5 |
Insurance contract or identification number | AN-2012001 | Number of Individuals Covered | 162 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,728 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 925217 |
Policy instance | 4 |
Insurance contract or identification number | 925217 | Number of Individuals Covered | 104 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,490 | Total amount of fees paid to insurance company | USD $3,379 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,490 | Amount paid for insurance broker fees | 3379 | Additional information about fees paid to insurance broker | BONUSES AND ADDITIONAL PAYMENTS | Insurance broker organization code? | 3 |
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KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
Policy contract number | 65129 |
Policy instance | 3 |
Insurance contract or identification number | 65129 | Number of Individuals Covered | 135 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,572 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,850 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,572 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1001004 |
Policy instance | 2 |
Insurance contract or identification number | 1001004 | Number of Individuals Covered | 148 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,426 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | MANAGED TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $14,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,426 | Insurance broker organization code? | 5 |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 1 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 148 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $245,458 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5482738 |
Policy instance | 4 |
Insurance contract or identification number | 5482738 | Number of Individuals Covered | 97 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,456 | Total amount of fees paid to insurance company | USD $2,538 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,448 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,456 | Amount paid for insurance broker fees | 2538 | Insurance broker organization code? | 3 |
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KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
Policy contract number | 65129 |
Policy instance | 3 |
Insurance contract or identification number | 65129 | Number of Individuals Covered | 147 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,654 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,741 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,654 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1001004 |
Policy instance | 2 |
Insurance contract or identification number | 1001004 | Number of Individuals Covered | 159 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,448 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | MANAGED TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $14,478 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,448 | Insurance broker organization code? | 5 |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 1 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 159 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $225,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5482738 |
Policy instance | 4 |
Insurance contract or identification number | 5482738 | Number of Individuals Covered | 94 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,273 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,273 | Insurance broker organization code? | 3 | Insurance broker name | CT SOLUTIONS DBA SONUS BENEFITS |
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KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
Policy contract number | 65129 |
Policy instance | 3 |
Insurance contract or identification number | 65129 | Number of Individuals Covered | 147 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,587 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,839 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,587 | Insurance broker organization code? | 3 | Insurance broker name | THOMAS VIERS |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1001004 |
Policy instance | 2 |
Insurance contract or identification number | 1001004 | Number of Individuals Covered | 159 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,395 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | MANAGED TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $13,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,395 | Insurance broker organization code? | 5 | Insurance broker name | BAC AGENCY, INC. |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 1 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 159 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $173,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1032494 |
Policy instance | 1 |
Insurance contract or identification number | 1032494 | Number of Individuals Covered | 206 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,772 | Total amount of fees paid to insurance company | USD $1,284 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,688 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,772 | Amount paid for insurance broker fees | 1284 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | CT SOLUTIONS LTD |
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HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 ) |
Policy contract number | 00242124 |
Policy instance | 2 |
Insurance contract or identification number | 00242124 | Number of Individuals Covered | 0 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $3,616 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,443 | Insurance broker organization code? | 3 | Insurance broker name | THE DANIEL & HENRY CO |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 3 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 144 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $270,312 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 ) |
Policy contract number | 00242124 |
Policy instance | 2 |
Insurance contract or identification number | 00242124 | Number of Individuals Covered | 246 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $17,043 | Total amount of fees paid to insurance company | USD $1,590 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $898,226 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,043 | Amount paid for insurance broker fees | 1590 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | THE DANIEL & HENRY CO |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-202053 |
Policy instance | 3 |
Insurance contract or identification number | UNI-202053 | Number of Individuals Covered | 149 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,941 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1032494 |
Policy instance | 1 |
Insurance contract or identification number | 1032494 | Number of Individuals Covered | 306 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,361 | Total amount of fees paid to insurance company | USD $2,143 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,816 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,214 | Amount paid for insurance broker fees | 2143 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | CT SOLUTIONS LTD |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6379600000 |
Policy instance | 1 |
Insurance contract or identification number | 6379600000 | Number of Individuals Covered | 254 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $19,781 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $860,038 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,781 | Insurance broker organization code? | 3 | Insurance broker name | DANIEL & HENRY |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1032494 |
Policy instance | 2 |
Insurance contract or identification number | 1032494 | Number of Individuals Covered | 281 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,275 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,861 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,275 | Insurance broker organization code? | 3 | Insurance broker name | DANIEL & HENRY |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 55646 |
Policy instance | 2 |
Insurance contract or identification number | 55646 | Number of Individuals Covered | 149 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,349 | Total amount of fees paid to insurance company | USD $49 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,070 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,107 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 49 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | Insurance broker name | AXA ASSISTANCE USA |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6379600000 |
Policy instance | 1 |
Insurance contract or identification number | 6379600000 | Number of Individuals Covered | 256 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $18,951 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $823,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,951 | Insurance broker organization code? | 3 | Insurance broker name | DANIEL & HENRY |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 55646 |
Policy instance | 2 |
Insurance contract or identification number | 55646 | Number of Individuals Covered | 148 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,245 | Total amount of fees paid to insurance company | USD $49 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,883 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 ) |
Policy contract number | 127788 |
Policy instance | 1 |
Insurance contract or identification number | 127788 | Number of Individuals Covered | 139 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $16,809 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $840,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 55646 |
Policy instance | 2 |
Insurance contract or identification number | 55646 | Number of Individuals Covered | 140 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,420 | Total amount of fees paid to insurance company | USD $47 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $22,760 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $282 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 47 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | Insurance broker name | AXA ASSISTANCE USA |
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HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 ) |
Policy contract number | 127788 |
Policy instance | 1 |
Insurance contract or identification number | 127788 | Number of Individuals Covered | 138 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $14,806 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $740,314 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,806 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES LLC |
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