LANTIS ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LANTIS ENTERPRISES HEALTH INSURANCE
Measure | Date | Value |
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2022: LANTIS ENTERPRISES HEALTH INSURANCE 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 913 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 261 |
Total of all active and inactive participants | 2022-01-01 | 261 |
Total participants | 2022-01-01 | 261 |
2021: LANTIS ENTERPRISES HEALTH INSURANCE 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 1,123 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 913 |
Total of all active and inactive participants | 2021-01-01 | 913 |
Total participants | 2021-01-01 | 913 |
2020: LANTIS ENTERPRISES HEALTH INSURANCE 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 1,012 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,123 |
Total of all active and inactive participants | 2020-01-01 | 1,123 |
Total participants | 2020-01-01 | 1,123 |
2019: LANTIS ENTERPRISES HEALTH INSURANCE 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 52 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,012 |
Total of all active and inactive participants | 2019-01-01 | 1,012 |
Total participants | 2019-01-01 | 1,012 |
Number of participants with account balances | 2019-01-01 | 0 |
2018: LANTIS ENTERPRISES HEALTH INSURANCE 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 34 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 52 |
Total of all active and inactive participants | 2018-01-01 | 52 |
Total participants | 2018-01-01 | 52 |
2017: LANTIS ENTERPRISES HEALTH INSURANCE 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 33 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 34 |
Total of all active and inactive participants | 2017-01-01 | 34 |
Total participants | 2017-01-01 | 34 |
2016: LANTIS ENTERPRISES HEALTH INSURANCE 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 31 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 33 |
Total of all active and inactive participants | 2016-01-01 | 33 |
Total participants | 2016-01-01 | 33 |
2015: LANTIS ENTERPRISES HEALTH INSURANCE 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 28 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 31 |
Total of all active and inactive participants | 2015-01-01 | 31 |
Total participants | 2015-01-01 | 0 |
2014: LANTIS ENTERPRISES HEALTH INSURANCE 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 22 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 28 |
Total of all active and inactive participants | 2014-01-01 | 28 |
Total participants | 2014-01-01 | 0 |
2013: LANTIS ENTERPRISES HEALTH INSURANCE 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 27 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 22 |
Total of all active and inactive participants | 2013-01-01 | 22 |
Total participants | 2013-01-01 | 0 |
2012: LANTIS ENTERPRISES HEALTH INSURANCE 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 457 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 27 |
Total of all active and inactive participants | 2012-01-01 | 27 |
Total participants | 2012-01-01 | 0 |
2011: LANTIS ENTERPRISES HEALTH INSURANCE 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 460 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 457 |
Total of all active and inactive participants | 2011-01-01 | 457 |
Total participants | 2011-01-01 | 457 |
2009: LANTIS ENTERPRISES HEALTH INSURANCE 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 401 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 474 |
Total of all active and inactive participants | 2009-01-01 | 474 |
Total participants | 2009-01-01 | 474 |
2022: LANTIS ENTERPRISES HEALTH INSURANCE 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
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: LANTIS ENTERPRISES HEALTH INSURANCE 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
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: LANTIS ENTERPRISES HEALTH INSURANCE 2020 form 5500 responses |
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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: LANTIS ENTERPRISES HEALTH INSURANCE 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Mulitple 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: LANTIS ENTERPRISES HEALTH INSURANCE 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Mulitple employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: LANTIS ENTERPRISES HEALTH INSURANCE 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Mulitple employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: LANTIS ENTERPRISES HEALTH INSURANCE 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Mulitple employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: LANTIS ENTERPRISES HEALTH INSURANCE 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Mulitple employer plan |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 228270 |
Policy instance | 2 |
Insurance contract or identification number | 228270 | Number of Individuals Covered | 238 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $53,668 | Health Insurance Welfare Benefit | Yes | Dental 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 $46,382 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 |
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IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | ERR000315-01 |
Policy instance | 1 |
Insurance contract or identification number | ERR000315-01 | Number of Individuals Covered | 23 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 228270 |
Policy instance | 2 |
Insurance contract or identification number | 228270 | Number of Individuals Covered | 887 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $91,450 | Health Insurance Welfare Benefit | Yes | Dental 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 $91,450 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | ERR000315-01 |
Policy instance | 1 |
Insurance contract or identification number | ERR000315-01 | Number of Individuals Covered | 26 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $72,382 | Health 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 $63,248 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 |
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IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | ERR000315-01 |
Policy instance | 1 |
Insurance contract or identification number | ERR000315-01 | Number of Individuals Covered | 27 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $65,699 | Health 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 $58,879 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 228270 |
Policy instance | 2 |
Insurance contract or identification number | 228270 | Number of Individuals Covered | 1022 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $91,530 | Health Insurance Welfare Benefit | Yes | Dental 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 $91,530 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 908222 |
Policy instance | 3 |
Insurance contract or identification number | 908222 | Number of Individuals Covered | 74 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-03-31 | Total amount of commissions paid to insurance broker | USD $561 | Dental Insurance Welfare Benefit | Yes | Life 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 $561 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 228270 |
Policy instance | 3 |
Insurance contract or identification number | 228270 | Number of Individuals Covered | 859 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $76,632 | Health Insurance Welfare Benefit | Yes | Dental 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 $76,632 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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IRONSHORE INDEMNITY INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | ERR000315-01 |
Policy instance | 2 |
Insurance contract or identification number | ERR000315-01 | Number of Individuals Covered | 27 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $52,794 | Total amount of fees paid to insurance company | USD $6,542 | Health 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 $52,794 | Amount paid for insurance broker fees | 6267 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 908222 |
Policy instance | 1 |
Insurance contract or identification number | 908222 | Number of Individuals Covered | 126 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,802 | Dental Insurance Welfare Benefit | Yes | Life 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 $1,676 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | ERR1117-17 |
Policy instance | 2 |
Insurance contract or identification number | ERR1117-17 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $37,024 | Total amount of fees paid to insurance company | USD $3,694 | Health 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 $37,024 | Amount paid for insurance broker fees | 3600 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 908222 |
Policy instance | 1 |
Insurance contract or identification number | 908222 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $458 | Dental Insurance Welfare Benefit | Yes | Life 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 $377 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | ERR1117-17 |
Policy instance | 2 |
Insurance contract or identification number | ERR1117-17 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $27,679 | Total amount of fees paid to insurance company | USD $4,408 | Health 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 $27,679 | Amount paid for insurance broker fees | 2692 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 | Insurance broker name | ALLEGIANCE COBRA SERVICES, INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466197 |
Policy instance | 1 |
Insurance contract or identification number | 5466197 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,736 | Dental Insurance Welfare Benefit | Yes | Life 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 $1,736 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT GREAT WEST INS SERVICES LLC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | ERR1117-15 |
Policy instance | 2 |
Insurance contract or identification number | ERR1117-15 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $24,786 | Total amount of fees paid to insurance company | USD $3,987 | Health 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 $24,786 | Amount paid for insurance broker fees | 2599 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 | Insurance broker name | ALLEGIANCE COBRA SERVICES, INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466197 |
Policy instance | 1 |
Insurance contract or identification number | 5466197 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,168 | Total amount of fees paid to insurance company | USD $114 | Dental Insurance Welfare Benefit | Yes | Life 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 $1,168 | Amount paid for insurance broker fees | 114 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT GREAT WEST INS SERVICES LLC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | ERR1117-14 |
Policy instance | 2 |
Insurance contract or identification number | ERR1117-14 | Number of Individuals Covered | 25 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $23,670 | Total amount of fees paid to insurance company | USD $3,343 | Health 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 $23,670 | Amount paid for insurance broker fees | 2410 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 | Insurance broker name | ALLEGIANCE COBRA SERVICES, INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466197 |
Policy instance | 1 |
Insurance contract or identification number | 5466197 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $862 | Total amount of fees paid to insurance company | USD $290 | Dental Insurance Welfare Benefit | Yes | Life 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 $862 | Amount paid for insurance broker fees | 290 | Additional information about fees paid to insurance broker | PRODUCER BONUS PROGRAM | Insurance broker organization code? | 3 | Insurance broker name | LEAVITT GREAT WEST INS SERVICES LLC |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | AJS00680-12 |
Policy instance | 1 |
Insurance contract or identification number | AJS00680-12 | Number of Individuals Covered | 22 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $16,437 | Total amount of fees paid to insurance company | USD $5,931 | Health 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 $16,437 | Amount paid for insurance broker fees | 4327 | Additional information about fees paid to insurance broker | ADMINSTRATION FEES | Insurance broker organization code? | 3 | Insurance broker name | PAYNE FINANCIAL GROUP |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466197 |
Policy instance | 2 |
Insurance contract or identification number | 5466197 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,009 | Dental Insurance Welfare Benefit | Yes | Life 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 $848 | Insurance broker name | COORDINATED CARE PARTNERS LLC |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | AJS00680-11 |
Policy instance | 2 |
Insurance contract or identification number | AJS00680-11 | Number of Individuals Covered | 27 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $71,385 | Total amount of fees paid to insurance company | USD $85,666 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2825 | Additional information about fees paid to insurance broker | CASE MANAGEMENT FEES | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $71,385 | Insurance broker name | INTERMOUNTAIN UNDERWRITERS |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5349604 |
Policy instance | 3 |
Insurance contract or identification number | 5349604 | Number of Individuals Covered | 425 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $4,303 | Total amount of fees paid to insurance company | USD $1,718 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1718 | Additional information about fees paid to insurance broker | PRODUCER PROGRAM PAYMENT | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $4,303 | Insurance broker name | PAYNEWEST INSURANCE INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466197 |
Policy instance | 1 |
Insurance contract or identification number | 5466197 | Number of Individuals Covered | 40 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $80 | Dental Insurance Welfare Benefit | Yes | Life 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 $80 | Insurance broker name | COORDINATED CARE PARTNERS LLC |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | AJS00680-10 |
Policy instance | 1 |
Insurance contract or identification number | AJS00680-10 | Number of Individuals Covered | 352 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $78,453 | Total amount of fees paid to insurance company | USD $96,595 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5349604 |
Policy instance | 2 |
Insurance contract or identification number | 5349604 | Number of Individuals Covered | 457 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,206 | Total amount of fees paid to insurance company | USD $998 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
Policy contract number | ERR9960-5070-02 |
Policy instance | 1 |
Insurance contract or identification number | ERR9960-5070-02 | Number of Individuals Covered | 375 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $71,995 | Health 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 $71,995 | Insurance broker name | INTERMOUNTAIN UNDERWRITERS |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5349604 |
Policy instance | 2 |
Insurance contract or identification number | 5349604 | Number of Individuals Covered | 460 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $5,019 | Total amount of fees paid to insurance company | USD $1,756 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Additional information about fees paid to insurance broker | PRODUCER PROGRAM PAYMENT | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,019 | Amount paid for insurance broker fees | 1756 | Insurance broker name | PAYNE FINANCIAL GROUP |
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