GREAT WESTERN BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D
401k plan membership statisitcs for GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D
| Measure | Date | Value |
|---|
| 2021: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,668 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 0 |
| 2020: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,617 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,648 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 20 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 1,668 |
| 2019: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,601 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,617 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 17 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 1,634 |
| 2018: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,592 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,601 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 25 |
| Total of all active and inactive participants | 2018-01-01 | 1,626 |
| 2017: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,951 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,592 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 23 |
| Total of all active and inactive participants | 2017-01-01 | 1,615 |
| 2016: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,408 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,591 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 23 |
| Total of all active and inactive participants | 2016-01-01 | 1,614 |
| 2015: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 1,381 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,408 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 10 |
| Total of all active and inactive participants | 2015-01-01 | 1,418 |
| 2014: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 1,399 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,392 |
| Total of all active and inactive participants | 2014-01-01 | 1,392 |
| 2013: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,469 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 1,399 |
| Total of all active and inactive participants | 2013-01-01 | 1,399 |
| 2012: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 1,452 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,469 |
| Total of all active and inactive participants | 2012-01-01 | 1,469 |
| 2011: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 1,199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,452 |
| Total of all active and inactive participants | 2011-01-01 | 1,452 |
| 2009: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 755 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 891 |
| Total of all active and inactive participants | 2009-01-01 | 891 |
| 2021: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2020 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2019 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2018 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2017 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2016 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2015 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2014 form 5500 responses |
|---|
| 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: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GREAT WESTERN BANK VOLUNTARY TERM LIFE & AD&D 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX969147 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX969147 | | Number of Individuals Covered | 1651 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,881 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,881 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK970601 |
| Policy instance | 2 |
| Insurance contract or identification number | OK970601 | | Number of Individuals Covered | 1651 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $4,748 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D AND VOLUNTARY AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $63,300 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,748 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX969147 |
| Policy instance | 1 |
| Insurance contract or identification number | FLX969147 | | Number of Individuals Covered | 1651 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $27,945 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | VOLUNTARY TERM LIFE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $372,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,945 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 970601 |
| Policy instance | 4 |
| Insurance contract or identification number | 970601 | | Number of Individuals Covered | 1648 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,368 | | Total amount of fees paid to insurance company | USD $538 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $58,240 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,368 | | Amount paid for insurance broker fees | 538 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 962913 |
| Policy instance | 3 |
| Insurance contract or identification number | 962913 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $19,305 | | Total amount of fees paid to insurance company | USD $2,461 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $257,404 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,305 | | Amount paid for insurance broker fees | 2461 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 969147 |
| Policy instance | 2 |
| Insurance contract or identification number | 969147 | | Number of Individuals Covered | 1648 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $25,258 | | Total amount of fees paid to insurance company | USD $3,238 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $338,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,258 | | Amount paid for insurance broker fees | 3238 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026256 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026256 | | Number of Individuals Covered | 1155 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,681 | | Total amount of fees paid to insurance company | USD $0 | | Vision 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 $4,681 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 3 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 786 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $14,717 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $14,717 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 2 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 1617 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $26,735 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,735 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026256 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026256 | | Number of Individuals Covered | 1110 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $5,167 | | Total amount of fees paid to insurance company | USD $0 | | Vision 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 $5,167 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 3 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 761 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $14,937 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $14,937 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 2 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 1601 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $27,878 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,878 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026256 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026256 | | Number of Individuals Covered | 1095 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 3 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 706 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $9,956 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability 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 $9,956 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH & BENEFITS |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 162381 |
| Policy instance | 2 |
| Insurance contract or identification number | 162381 | | Number of Individuals Covered | 1592 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $21,357 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,357 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH & BENEFITS |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026256 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026256 | | Number of Individuals Covered | 1103 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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