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NPG MEDICAL PLAN 401k Plan overview

Plan NameNPG MEDICAL PLAN
Plan identification number 507

NPG MEDICAL PLAN Benefits

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

401k Sponsoring company profile

NEWS-PRESS & GAZETTE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:NEWS-PRESS & GAZETTE COMPANY
Employer identification number (EIN):440371250
NAIC Classification:511110
NAIC Description:Newspaper Publishers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NPG MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072023-01-01
5072022-01-01
5072021-01-01
5072020-01-01
5072019-01-01
5072018-01-01
5072017-01-01JENNIFER WRIGHT
5072017-01-01JENNIFER WRIGHT
5072016-01-01JENNIFER WRIGHT
5072015-01-01JENNIFER WRIGHT
5072014-01-01BILL SEVERN
5072013-01-01BILL SEVERN
5072012-01-01BILL SEVERN
5072011-01-01LYLE LEIMKUHLER
5072010-01-01LYLE LEIMKUHLER
5072009-01-01 LYLE LEIMKUHLER2011-02-03
5072008-01-01 LYLE LEIMKUHLER2011-02-03
5072007-01-01 LYLE LEIMKUHLER2011-02-03
5072006-01-01 LYLE LEIMKUHLER2011-02-03
5072005-01-01 LYLE LEIMKUHLER2011-02-03

Plan Statistics for NPG MEDICAL PLAN

401k plan membership statisitcs for NPG MEDICAL PLAN

Measure Date Value
2023: NPG MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01563
Total number of active participants reported on line 7a of the Form 55002023-01-01495
Number of retired or separated participants receiving benefits2023-01-016
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01501
2022: NPG MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01574
Total number of active participants reported on line 7a of the Form 55002022-01-01555
Number of retired or separated participants receiving benefits2022-01-018
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01563
2021: NPG MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01707
Total number of active participants reported on line 7a of the Form 55002021-01-01557
Number of retired or separated participants receiving benefits2021-01-0117
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01574
2020: NPG MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01836
Total number of active participants reported on line 7a of the Form 55002020-01-01695
Number of retired or separated participants receiving benefits2020-01-0112
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01707
2019: NPG MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01671
Total number of active participants reported on line 7a of the Form 55002019-01-01822
Number of retired or separated participants receiving benefits2019-01-0114
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01836
2018: NPG MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01674
Total number of active participants reported on line 7a of the Form 55002018-01-01671
Number of retired or separated participants receiving benefits2018-01-0113
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01684
2017: NPG MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01650
Total number of active participants reported on line 7a of the Form 55002017-01-01663
Number of retired or separated participants receiving benefits2017-01-0111
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01674
2016: NPG MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01531
Total number of active participants reported on line 7a of the Form 55002016-01-01637
Number of retired or separated participants receiving benefits2016-01-0112
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01649
2015: NPG MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01529
Total number of active participants reported on line 7a of the Form 55002015-01-01531
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 participants2015-01-01531
2014: NPG MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01453
Total number of active participants reported on line 7a of the Form 55002014-01-01529
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 participants2014-01-01529
2013: NPG MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01416
Total number of active participants reported on line 7a of the Form 55002013-01-01453
Total of all active and inactive participants2013-01-01453
2012: NPG MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01419
Total number of active participants reported on line 7a of the Form 55002012-01-01416
Total of all active and inactive participants2012-01-01416
2011: NPG MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01753
Total number of active participants reported on line 7a of the Form 55002011-01-01419
Total of all active and inactive participants2011-01-01419
2010: NPG MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01788
Total number of active participants reported on line 7a of the Form 55002010-01-01753
Total of all active and inactive participants2010-01-01753
2009: NPG MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01797
Total number of active participants reported on line 7a of the Form 55002009-01-01788
Total of all active and inactive participants2009-01-01788
Total participants2009-01-01788
2008: NPG MEDICAL PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01755
Total number of active participants reported on line 7a of the Form 55002008-01-01797
Total of all active and inactive participants2008-01-01797
Total participants2008-01-01797
2007: NPG MEDICAL PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01614
Total number of active participants reported on line 7a of the Form 55002007-01-01755
Total of all active and inactive participants2007-01-01755
Total participants2007-01-01755
2006: NPG MEDICAL PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01529
Total number of active participants reported on line 7a of the Form 55002006-01-01614
Total of all active and inactive participants2006-01-01614
Total participants2006-01-01614
2005: NPG MEDICAL PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01462
Total number of active participants reported on line 7a of the Form 55002005-01-01529
Total of all active and inactive participants2005-01-01529
Total participants2005-01-01529

Form 5500 Responses for NPG MEDICAL PLAN

2023: NPG MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: NPG MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NPG MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NPG MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NPG MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NPG MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: NPG MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: NPG MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: NPG MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NPG MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: NPG MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: NPG MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: NPG MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: NPG MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: NPG MEDICAL PLAN 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
2008: NPG MEDICAL PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: NPG MEDICAL PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: NPG MEDICAL PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: NPG MEDICAL PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 2
Insurance contract or identification number00507349
Number of Individuals Covered504
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of fees paid to insurance companyUSD $16,625
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $468,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-5944M
Policy instance 1
Insurance contract or identification number71-5944M
Number of Individuals Covered495
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $81,199
Total amount of fees paid to insurance companyUSD $12,626
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 2
Insurance contract or identification number00507349
Number of Individuals Covered559
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $19,372
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $433,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees19372
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-5944M
Policy instance 1
Insurance contract or identification number71-5944M
Number of Individuals Covered555
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $36,876
Total amount of fees paid to insurance companyUSD $13,512
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 $36,876
Amount paid for insurance broker fees13512
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 2
Insurance contract or identification number00507349
Number of Individuals Covered554
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $11,725
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11725
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number71-5944M-99
Policy instance 1
Insurance contract or identification number71-5944M-99
Number of Individuals Covered560
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $36,876
Total amount of fees paid to insurance companyUSD $14,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,876
Amount paid for insurance broker fees14152
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered1255
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $36,876
Total amount of fees paid to insurance companyUSD $161,907
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 $36,876
Amount paid for insurance broker fees161907
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 2
Insurance contract or identification number00507349
Number of Individuals Covered677
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $14,725
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $489,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14725
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00561155
Policy instance 3
Insurance contract or identification number00561155
Number of Individuals Covered97
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,194
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,194
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered1517
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $30,780
Total amount of fees paid to insurance companyUSD $135,434
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 $30,780
Amount paid for insurance broker fees135434
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 2
Insurance contract or identification number00507349
Number of Individuals Covered671
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $11,154
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $515,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11154
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered1246
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $29,916
Total amount of fees paid to insurance companyUSD $115,836
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 $29,916
Amount paid for insurance broker fees115836
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1051570
Policy instance 2
Insurance contract or identification number1051570
Number of Individuals Covered91
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,880
Total amount of fees paid to insurance companyUSD $357
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,880
Amount paid for insurance broker fees357
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number271312
Policy instance 3
Insurance contract or identification number271312
Number of Individuals Covered45
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $10,550
Total amount of fees paid to insurance companyUSD $812
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 $8,428
Amount paid for insurance broker fees812
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98739771001
Policy instance 4
Insurance contract or identification number98739771001
Number of Individuals Covered99
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $557
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $557
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 5
Insurance contract or identification number00507349
Number of Individuals Covered607
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $12,180
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $412,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12180
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00271312/0002
Policy instance 6
Insurance contract or identification number00271312/0002
Number of Individuals Covered85
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $16,629
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $300,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,629
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered1205
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $26,604
Total amount of fees paid to insurance companyUSD $101,906
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 $26,604
Amount paid for insurance broker fees101906
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1051570
Policy instance 2
Insurance contract or identification number1051570
Number of Individuals Covered116
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $1,984
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,984
Insurance broker organization code?3
Insurance broker nameJ DEMPSEY INCORPORATED
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-533
Policy instance 3
Insurance contract or identification number09149-533
Number of Individuals Covered130
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $20,637
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $461,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,637
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 5
Insurance contract or identification number00507349
Number of Individuals Covered629
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $14,857
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $494,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14857
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98739771001
Policy instance 4
Insurance contract or identification number98739771001
Number of Individuals Covered103
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $539
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $539
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number00271312/0002
Policy instance 6
Insurance contract or identification number00271312/0002
Number of Individuals Covered85
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9873977
Policy instance 4
Insurance contract or identification number9873977
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number6396000000
Policy instance 2
Insurance contract or identification number6396000000
Number of Individuals Covered82
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $19,448
Total amount of fees paid to insurance companyUSD $720
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $270,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,448
Amount paid for insurance broker fees720
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP, INC.
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9873977
Policy instance 7
Insurance contract or identification number9873977
Number of Individuals Covered73
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $347
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $347
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
WILLAMETTE DENTAL OF IDAHO, INC. (National Association of Insurance Commissioners NAIC id number: 95819 )
Policy contract numberID223/Z640
Policy instance 6
Insurance contract or identification numberID223/Z640
Number of Individuals Covered59
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,492
Total amount of fees paid to insurance companyUSD $2,387
Dental 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 $1,492
Amount paid for insurance broker fees2387
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICE FEE
Insurance broker organization code?3
Insurance broker nameBLACK INK SOLUTIONS
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered987
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $43,200
Total amount of fees paid to insurance companyUSD $84,896
Health Insurance Welfare BenefitYes
Dental 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 $43,200
Amount paid for insurance broker fees84896
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number278005
Policy instance 3
Insurance contract or identification number278005
Number of Individuals Covered119
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $22,244
Total amount of fees paid to insurance companyUSD $11,122
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $554,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11122
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $22,244
Insurance broker nameRONALD N. SELLIN
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-533
Policy instance 4
Insurance contract or identification number09149-533
Number of Individuals Covered114
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $19,481
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $370,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,481
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00507349
Policy instance 5
Insurance contract or identification number00507349
Number of Individuals Covered616
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered964
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $25,008
Total amount of fees paid to insurance companyUSD $71,755
Health Insurance Welfare BenefitYes
Dental 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 $25,008
Amount paid for insurance broker fees71755
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number6396000000
Policy instance 2
Insurance contract or identification number6396000000
Number of Individuals Covered83
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,862
Total amount of fees paid to insurance companyUSD $6,780
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $279,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,862
Amount paid for insurance broker fees6780
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP, INC.
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number278005
Policy instance 3
Insurance contract or identification number278005
Number of Individuals Covered137
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $20,391
Total amount of fees paid to insurance companyUSD $10,195
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $510,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10195
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $20,391
Insurance broker nameRONALD N. SELLIN
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-533
Policy instance 4
Insurance contract or identification number09149-533
Number of Individuals Covered85
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $11,585
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $295,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,585
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00388256
Policy instance 6
Insurance contract or identification number00388256
Number of Individuals Covered44
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,048
Total amount of fees paid to insurance companyUSD $1,783
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,038
Amount paid for insurance broker fees1783
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameDAVID G. BOYKIN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-026979
Policy instance 5
Insurance contract or identification number010-026979
Number of Individuals Covered917
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $2,443
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2443
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
WILLAMETTE DENTAL OF IDAHO, INC. (National Association of Insurance Commissioners NAIC id number: 95819 )
Policy contract numberID223/Z640
Policy instance 7
Insurance contract or identification numberID223/Z640
Number of Individuals Covered70
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,468
Dental 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 $1,468
Insurance broker organization code?3
Insurance broker nameBLACK INK SOLUTIONS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9873977
Policy instance 8
Insurance contract or identification number9873977
Number of Individuals Covered56
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $242
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $242
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered856
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $23,532
Total amount of fees paid to insurance companyUSD $70,135
Health Insurance Welfare BenefitYes
Dental 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 $23,532
Amount paid for insurance broker fees70135
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number00166572
Policy instance 2
Insurance contract or identification number00166572
Number of Individuals Covered91
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,137
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,137
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number228350
Policy instance 3
Insurance contract or identification number228350
Number of Individuals Covered139
Insurance policy start date2013-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $32,537
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $658,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,537
Insurance broker organization code?3
Insurance broker nameRONALD SELLIN
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-533
Policy instance 4
Insurance contract or identification number09149-533
Number of Individuals Covered58
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $9,049
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $186,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,049
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-026979
Policy instance 5
Insurance contract or identification number010-026979
Number of Individuals Covered827
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $1,520
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1520
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00388256
Policy instance 6
Insurance contract or identification number00388256
Number of Individuals Covered46
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,052
Total amount of fees paid to insurance companyUSD $1,662
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,024
Amount paid for insurance broker fees1662
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameDAVID G. BOYKIN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-026979
Policy instance 5
Insurance contract or identification number010-026979
Number of Individuals Covered794
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $426
Total amount of fees paid to insurance companyUSD $1,439
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $426
Amount paid for insurance broker fees1439
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number228350
Policy instance 3
Insurance contract or identification number228350
Number of Individuals Covered261
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $29,314
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $548,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,314
Insurance broker organization code?3
Insurance broker nameRONALD SELLIN
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number09149-533
Policy instance 4
Insurance contract or identification number09149-533
Number of Individuals Covered46
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $7,146
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,146
Insurance broker organization code?3
Insurance broker nameDEMPSEY INC.
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract number00166572
Policy instance 2
Insurance contract or identification number00166572
Number of Individuals Covered89
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,396
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $254,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,396
Insurance broker organization code?3
Insurance broker nameTHE INSURANCE GROUP INC.
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered796
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $21,468
Total amount of fees paid to insurance companyUSD $56,803
Health Insurance Welfare BenefitYes
Dental 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 $21,468
Amount paid for insurance broker fees56803
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered812
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $27,972
Total amount of fees paid to insurance companyUSD $100,781
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number17031000
Policy instance 1
Insurance contract or identification number17031000
Number of Individuals Covered1462
Insurance policy start date2009-04-01
Insurance policy end date2010-03-31
Total amount of commissions paid to insurance brokerUSD $29,736
Total amount of fees paid to insurance companyUSD $106,588
Health Insurance Welfare BenefitYes
Dental 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 $29,736
Amount paid for insurance broker fees106588
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
Insurance broker nameCBIZ BENEFITS & INSURANCE SERVICES

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