ENERGY TRANSPORTATION, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ENERGY TRANSPORTATION, LLC WELFARE PLAN
Measure | Date | Value |
---|
2022: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 1,313 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,002 |
Total of all active and inactive participants | 2022-01-01 | 1,002 |
2021: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 559 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 563 |
Total of all active and inactive participants | 2021-01-01 | 563 |
2020: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-09-01 | 378 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 559 |
Number of retired or separated participants receiving benefits | 2020-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
Total of all active and inactive participants | 2020-09-01 | 559 |
Number of employers contributing to the scheme | 2020-09-01 | 0 |
2019: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-09-01 | 463 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 378 |
Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
Total of all active and inactive participants | 2019-09-01 | 378 |
Number of employers contributing to the scheme | 2019-09-01 | 0 |
2018: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-09-01 | 313 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 307 |
Number of retired or separated participants receiving benefits | 2018-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
Total of all active and inactive participants | 2018-09-01 | 307 |
Number of employers contributing to the scheme | 2018-09-01 | 0 |
2017: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-09-01 | 126 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 313 |
Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
Total of all active and inactive participants | 2017-09-01 | 313 |
Number of employers contributing to the scheme | 2017-09-01 | 0 |
2016: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-09-01 | 103 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 126 |
Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
Total of all active and inactive participants | 2016-09-01 | 126 |
2022: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2022 form 5500 responses |
---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
2022-01-01 | This submission is the final filing | No |
2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-01-01 | Plan is a collectively bargained plan | No |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: ENERGY TRANSPORTATION, LLC WELFARE PLAN 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 benefit arrangement – Insurance | Yes |
2020: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2020 form 5500 responses |
---|
2020-09-01 | Type of plan entity | Single employer plan |
2020-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2020-09-01 | Plan funding arrangement – Insurance | Yes |
2020-09-01 | Plan benefit arrangement – Insurance | Yes |
2019: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2019 form 5500 responses |
---|
2019-09-01 | Type of plan entity | Single employer plan |
2019-09-01 | Plan funding arrangement – Insurance | Yes |
2019-09-01 | Plan benefit arrangement – Insurance | Yes |
2018: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2018 form 5500 responses |
---|
2018-09-01 | Type of plan entity | Single employer plan |
2018-09-01 | Plan funding arrangement – Insurance | Yes |
2018-09-01 | Plan benefit arrangement – Insurance | Yes |
2017: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2017 form 5500 responses |
---|
2017-09-01 | Type of plan entity | Single employer plan |
2017-09-01 | Plan funding arrangement – Insurance | Yes |
2017-09-01 | Plan benefit arrangement – Insurance | Yes |
2016: ENERGY TRANSPORTATION, LLC WELFARE PLAN 2016 form 5500 responses |
---|
2016-09-01 | Type of plan entity | Single employer plan |
2016-09-01 | First time form 5500 has been submitted | Yes |
2016-09-01 | Submission has been amended | No |
2016-09-01 | This submission is the final filing | No |
2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-09-01 | Plan is a collectively bargained plan | No |
2016-09-01 | Plan funding arrangement – Insurance | Yes |
2016-09-01 | Plan benefit arrangement – Insurance | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5973991 |
Policy instance | 2 |
Insurance contract or identification number | 5973991 | Number of Individuals Covered | 1002 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $90,633 | Total amount of fees paid to insurance company | USD $32,472 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | 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 $425,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $65,732 | Amount paid for insurance broker fees | 3750 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0232987 |
Policy instance | 1 |
Insurance contract or identification number | 0232987 | Number of Individuals Covered | 313 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $23,202 | Total amount of fees paid to insurance company | USD $1,696 | 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 | Yes | 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 | 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 $37,102 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,364 | Amount paid for insurance broker fees | 16 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5973991 |
Policy instance | 3 |
Insurance contract or identification number | 5973991 | Number of Individuals Covered | 1313 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $57,671 | Total amount of fees paid to insurance company | USD $20,458 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | 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 $506,123 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,917 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 6701 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0232987 |
Policy instance | 2 |
Insurance contract or identification number | 0232987 | Number of Individuals Covered | 166 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,852 | Total amount of fees paid to insurance company | USD $1,258 | 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 | Yes | 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 | 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 $27,427 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,578 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1258 | Additional information about fees paid to insurance broker | TPA ADMIN FEES |
|
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
Policy contract number | 272794 |
Policy instance | 1 |
Insurance contract or identification number | 272794 | Number of Individuals Covered | 717 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $107,937 | 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 | Yes | 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 | 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 $3,949,176 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $107,937 | Insurance broker organization code? | 3 |
|
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 5413830010 |
Policy instance | 2 |
Insurance contract or identification number | 5413830010 | Number of Individuals Covered | 559 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,448 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $1,448 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0B894 |
Policy instance | 3 |
Insurance contract or identification number | GLUG0B894 | Number of Individuals Covered | 559 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $11,828 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $154,993 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,828 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 ) |
Policy contract number | 105000901ET AL |
Policy instance | 1 |
Insurance contract or identification number | 105000901ET AL | Number of Individuals Covered | 279 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $30,347 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,461,859 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,347 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUDS0B894 |
Policy instance | 3 |
Insurance contract or identification number | GUDS0B894 | Number of Individuals Covered | 526 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $32,811 | Total amount of fees paid to insurance company | USD $21,094 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $417,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,811 | Amount paid for insurance broker fees | 21094 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 ) |
Policy contract number | 105000901ET AL |
Policy instance | 1 |
Insurance contract or identification number | 105000901ET AL | Number of Individuals Covered | 952 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $183,315 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,136,278 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $117,401 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 5413830010 |
Policy instance | 2 |
Insurance contract or identification number | 5413830010 | Number of Individuals Covered | 302 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $4,760 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $47,601 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,760 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0B894 |
Policy instance | 3 |
Insurance contract or identification number | GLUG0B894 | Number of Individuals Covered | 496 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $31,014 | Total amount of fees paid to insurance company | USD $15,218 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $417,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,014 | Amount paid for insurance broker fees | 15218 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 5413830010 |
Policy instance | 2 |
Insurance contract or identification number | 5413830010 | Number of Individuals Covered | 428 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $5,045 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,045 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
HEALTH PLAN UPPER OHIO VALLEY (National Association of Insurance Commissioners NAIC id number: 95677 ) |
Policy contract number | 125809202 |
Policy instance | 1 |
Insurance contract or identification number | 125809202 | Number of Individuals Covered | 899 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $62,254 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,929,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $62,254 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0B894 |
Policy instance | 4 |
Insurance contract or identification number | GLUG0B894 | Number of Individuals Covered | 417 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $4,789 | Total amount of fees paid to insurance company | USD $134 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | 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 | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $113,272 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 5413830010DVIO |
Policy instance | 3 |
Insurance contract or identification number | 5413830010DVIO | Number of Individuals Covered | 301 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $2,383 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,829 | 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 number | 776244 |
Policy instance | 2 |
Insurance contract or identification number | 776244 | Number of Individuals Covered | 208 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2017-11-30 | Total amount of commissions paid to insurance broker | USD $1,876 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $18,777 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
Policy contract number | 196451 |
Policy instance | 1 |
Insurance contract or identification number | 196451 | Number of Individuals Covered | 593 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $84,037 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,575,452 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|