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TMONE LLC HWBP 401k Plan overview

Plan NameTMONE LLC HWBP
Plan identification number 501

TMONE LLC HWBP Benefits

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

401k Sponsoring company profile

TMONE has sponsored the creation of one or more 401k plans.

Company Name:TMONE
Employer identification number (EIN):463195651
NAIC Classification:561420

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TMONE LLC HWBP

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01
5012020-09-01
5012019-09-01
5012018-09-01
5012017-09-01
5012016-09-01ANTHONY MARLOWE
5012015-09-01ANTHONY MARLOWE
5012014-09-01ANTHONY MARLOWE
5012013-09-01F. MICHAEL HARRISON F. MICHAEL HARRISON2015-04-01

Plan Statistics for TMONE LLC HWBP

401k plan membership statisitcs for TMONE LLC HWBP

Measure Date Value
2021: TMONE LLC HWBP 2021 401k membership
Total participants, beginning-of-year2021-09-01628
Total number of active participants reported on line 7a of the Form 55002021-09-01583
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01583
2020: TMONE LLC HWBP 2020 401k membership
Total participants, beginning-of-year2020-09-01217
Total number of active participants reported on line 7a of the Form 55002020-09-01628
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01628
2019: TMONE LLC HWBP 2019 401k membership
Total participants, beginning-of-year2019-09-01101
Total number of active participants reported on line 7a of the Form 55002019-09-01217
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01217
2018: TMONE LLC HWBP 2018 401k membership
Total participants, beginning-of-year2018-09-01191
Total number of active participants reported on line 7a of the Form 55002018-09-01101
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01101
2017: TMONE LLC HWBP 2017 401k membership
Total participants, beginning-of-year2017-09-01108
Total number of active participants reported on line 7a of the Form 55002017-09-01191
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01191
2016: TMONE LLC HWBP 2016 401k membership
Total participants, beginning-of-year2016-09-01111
Total number of active participants reported on line 7a of the Form 55002016-09-01108
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01108
2015: TMONE LLC HWBP 2015 401k membership
Total participants, beginning-of-year2015-09-01326
Total number of active participants reported on line 7a of the Form 55002015-09-01111
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01111
2014: TMONE LLC HWBP 2014 401k membership
Total participants, beginning-of-year2014-09-01428
Total number of active participants reported on line 7a of the Form 55002014-09-01326
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01326
2013: TMONE LLC HWBP 2013 401k membership
Total participants, beginning-of-year2013-09-01428
Total number of active participants reported on line 7a of the Form 55002013-09-01428
Total of all active and inactive participants2013-09-01428
Total participants2013-09-01428

Form 5500 Responses for TMONE LLC HWBP

2021: TMONE LLC HWBP 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: TMONE LLC HWBP 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: TMONE LLC HWBP 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: TMONE LLC HWBP 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: TMONE LLC HWBP 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: TMONE LLC HWBP 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: TMONE LLC HWBP 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: TMONE LLC HWBP 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: TMONE LLC HWBP 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01First time form 5500 has been submittedYes
2013-09-01Submission has been amendedYes
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number34419
Policy instance 4
Insurance contract or identification number34419
Number of Individuals Covered474
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $11,427
Total amount of fees paid to insurance companyUSD $2,489
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $241,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,427
Amount paid for insurance broker fees2489
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5938739
Policy instance 3
Insurance contract or identification number5938739
Number of Individuals Covered721
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $7,958
Total amount of fees paid to insurance companyUSD $1,493
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,958
Amount paid for insurance broker fees1493
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number0078,2930,7341
Policy instance 2
Insurance contract or identification number0078,2930,7341
Number of Individuals Covered283
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $36,104
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $354,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,104
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number752720
Policy instance 1
Insurance contract or identification number752720
Number of Individuals Covered7
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of fees paid to insurance companyUSD $852
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees852
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 1
Insurance contract or identification number0752720
Number of Individuals Covered14
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of fees paid to insurance companyUSD $2,496
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $343,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2496
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number0078,2930,7341
Policy instance 2
Insurance contract or identification number0078,2930,7341
Number of Individuals Covered590
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $33,943
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $381,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,943
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5938739
Policy instance 3
Insurance contract or identification number5938739
Number of Individuals Covered1317
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $7,427
Total amount of fees paid to insurance companyUSD $980
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,427
Amount paid for insurance broker fees980
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number34419
Policy instance 4
Insurance contract or identification number34419
Number of Individuals Covered890
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $11,575
Total amount of fees paid to insurance companyUSD $1,578
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $257,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,575
Amount paid for insurance broker fees1578
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 1
Insurance contract or identification number0752720
Number of Individuals Covered158
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $24
Total amount of fees paid to insurance companyUSD $4,524
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $444,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24
Amount paid for insurance broker fees4536
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number8938020
Policy instance 2
Insurance contract or identification number8938020
Number of Individuals Covered94
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $12,687
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,687
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5938739
Policy instance 3
Insurance contract or identification number5938739
Number of Individuals Covered353
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $2,442
Total amount of fees paid to insurance companyUSD $436
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,442
Amount paid for insurance broker fees436
Additional information about fees paid to insurance brokerNON-MONETARY/SUPPLEMENTAL COMP. MARKETING FEES
Insurance broker organization code?3
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number34419
Policy instance 4
Insurance contract or identification number34419
Number of Individuals Covered229
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $5,153
Total amount of fees paid to insurance companyUSD $1,261
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,153
Amount paid for insurance broker fees1261
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number8920078
Policy instance 2
Insurance contract or identification number8920078
Number of Individuals Covered101
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $8,015
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,015
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5938739
Policy instance 3
Insurance contract or identification number5938739
Number of Individuals Covered310
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $2,437
Total amount of fees paid to insurance companyUSD $514
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,437
Amount paid for insurance broker fees514
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 1
Insurance contract or identification number0752720
Number of Individuals Covered36
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of fees paid to insurance companyUSD $5,232
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5232
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05938739
Policy instance 4
Insurance contract or identification numberKM05938739
Number of Individuals Covered289
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,476
Total amount of fees paid to insurance companyUSD $326
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number8920078
Policy instance 3
Insurance contract or identification number8920078
Number of Individuals Covered65
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $8,214
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 2
Insurance contract or identification number0752720
Number of Individuals Covered44
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of fees paid to insurance companyUSD $7,224
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $364,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number34419
Policy instance 1
Insurance contract or identification number34419
Number of Individuals Covered191
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $3,066
Total amount of fees paid to insurance companyUSD $667
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,944
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 number60790-1160
Policy instance 4
Insurance contract or identification number60790-1160
Number of Individuals Covered142
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $3,969
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,166
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number8920078
Policy instance 3
Insurance contract or identification number8920078
Number of Individuals Covered58
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $5,814
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,799
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 2
Insurance contract or identification number0752720
Number of Individuals Covered88
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $322
Total amount of fees paid to insurance companyUSD $13,800
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $571,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $117
Amount paid for insurance broker fees3156
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL DBA THE BAILEY GROUP
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1458
Policy instance 1
Insurance contract or identification number1458
Number of Individuals Covered111
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $3,580
Total amount of fees paid to insurance companyUSD $1,105
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,289
Insurance broker organization code?3
Amount paid for insurance broker fees1105
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY
Insurance broker nameMFB FINANCIAL DBA THE BAILEY GROUP
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1024
Policy instance 1
Insurance contract or identification number1024
Number of Individuals Covered174
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $4,227
Total amount of fees paid to insurance companyUSD $42
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,227
Amount paid for insurance broker fees42
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL DBA THE BAILEY GROUP
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 2
Insurance contract or identification number0752720
Number of Individuals Covered326
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $370
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $370
Insurance broker organization code?3
Insurance broker nameMFB FINANCIAL DBA THE BAILEY GROUP
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number60790-1160
Policy instance 3
Insurance contract or identification number60790-1160
Number of Individuals Covered221
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $5,958
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,837
Insurance broker organization code?3
Insurance broker nameSELECT NETWORKS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 3
Insurance contract or identification number0752720
Number of Individuals Covered428
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $424
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $193
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameHOLMES-MURPHY & ASSOC INC
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1024
Policy instance 2
Insurance contract or identification number1024
Number of Individuals Covered198
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $5,220
Total amount of fees paid to insurance companyUSD $235
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $93,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,220
Amount paid for insurance broker fees235
Additional information about fees paid to insurance brokerSALES AND PERSISTENCY BONUS
Insurance broker organization code?3
Insurance broker nameHOLMES MURPHY
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 4
Insurance contract or identification number0752720
Number of Individuals Covered428
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $424
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $193
Insurance broker organization code?3
Insurance broker nameHOLMES-MURPHY & ASSOC INC
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number1024
Policy instance 3
Insurance contract or identification number1024
Number of Individuals Covered198
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $5,220
Total amount of fees paid to insurance companyUSD $235
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $93,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0752720
Policy instance 2
Insurance contract or identification number0752720
Number of Individuals Covered428
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $424
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $4,622
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 number60790-1160
Policy instance 1
Insurance contract or identification number60790-1160
Number of Individuals Covered233
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $5,754
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $27,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,014
Insurance broker organization code?3
Insurance broker nameHOLMES, MURPHY & ASSOCIATES

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