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GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameGULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN
Plan identification number 501

GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

GULFSPAN INDUSTRIAL, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name:GULFSPAN INDUSTRIAL, L.L.C.
Employer identification number (EIN):450910052
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Additional information about GULFSPAN INDUSTRIAL, L.L.C.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2011-03-21
Company Identification Number: 0801400381
Legal Registered Office Address: PO BOX 20318

BEAUMONT
United States of America (USA)
77720

More information about GULFSPAN INDUSTRIAL, L.L.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01VINCENT G. DUPLISSEY2023-02-08
5012020-08-01VINCENT G. DUPLISSEY2021-10-20
5012019-08-01VINCENT G. DUPLISSEY2020-10-28
5012018-08-01VINCENT G. DUPLISSEY2020-02-06
5012017-08-01
5012016-08-01
5012015-08-01
5012014-08-01
5012013-08-01
5012012-08-01VINCENT G. DUPLISSEY

Plan Statistics for GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN

Measure Date Value
2021: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01146
Total number of active participants reported on line 7a of the Form 55002021-08-01150
Total of all active and inactive participants2021-08-01150
2020: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01159
Total number of active participants reported on line 7a of the Form 55002020-08-01146
Total of all active and inactive participants2020-08-01146
2019: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01214
Total number of active participants reported on line 7a of the Form 55002019-08-01159
Total of all active and inactive participants2019-08-01159
2018: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01233
Total number of active participants reported on line 7a of the Form 55002018-08-01214
Total of all active and inactive participants2018-08-01214
2017: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01275
Total number of active participants reported on line 7a of the Form 55002017-08-01233
Total of all active and inactive participants2017-08-01233
2016: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01326
Total number of active participants reported on line 7a of the Form 55002016-08-01275
Total of all active and inactive participants2016-08-01275
2015: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01256
Total number of active participants reported on line 7a of the Form 55002015-08-01326
Total of all active and inactive participants2015-08-01326
2014: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01243
Total number of active participants reported on line 7a of the Form 55002014-08-01256
Total of all active and inactive participants2014-08-01256
2013: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01220
Total number of active participants reported on line 7a of the Form 55002013-08-01243
Total of all active and inactive participants2013-08-01243
2012: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-010
Total number of active participants reported on line 7a of the Form 55002012-08-01220
Total of all active and inactive participants2012-08-01220

Form 5500 Responses for GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN

2021: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2017: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: GULFSPAN INDUSTRIAL, L.L.C. HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01First time form 5500 has been submittedYes
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered70
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $799
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $799
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered147
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $58,514
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,486,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,514
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered75
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $473
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $473
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered150
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $37,215
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,068,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,215
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered57
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $448
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $448
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered146
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $36,616
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $981,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,616
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered61
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $414
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $414
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered159
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $51,559
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,489,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,559
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered214
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $57,497
Total amount of fees paid to insurance companyUSD $1,248
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,457,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,497
Amount paid for insurance broker fees1248
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered115
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $746
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $746
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered233
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $58,293
Total amount of fees paid to insurance companyUSD $1,812
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,474,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered114
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $748
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered113
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $618
Total amount of fees paid to insurance companyUSD $186
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $618
Amount paid for insurance broker fees186
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered326
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $35,790
Total amount of fees paid to insurance companyUSD $1,284
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,245,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,790
Amount paid for insurance broker fees1284
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered256
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $28,234
Total amount of fees paid to insurance companyUSD $1,032
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $975,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,234
Amount paid for insurance broker fees1032
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered97
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $553
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $553
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered101
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $509
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $509
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered243
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $22,839
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $776,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,839
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGAE20152
Policy instance 2
Insurance contract or identification numberGAE20152
Number of Individuals Covered87
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $411
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $411
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number109364
Policy instance 1
Insurance contract or identification number109364
Number of Individuals Covered220
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $27,292
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $546,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,292
Insurance broker organization code?3
Insurance broker nameSHERLOCK INSURANCE AGENCY, INC.

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