AMERI-NATIONAL CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AMERI-NATIONAL CORPORATION BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2022: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 446 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 425 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 425 |
| 2021: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 420 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 446 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 446 |
| 2020: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 360 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 420 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 420 |
| 2019: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 316 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 360 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 360 |
| 2018: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 314 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 316 |
| 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 | 316 |
| 2017: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 294 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 314 |
| 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 | 314 |
| 2016: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 294 |
| 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 | 294 |
| 2015: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 244 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 264 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 264 |
| 2014: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 244 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 244 |
| 2013: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 234 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 219 |
| Total of all active and inactive participants | 2013-09-01 | 219 |
| 2012: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 236 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 234 |
| Total of all active and inactive participants | 2012-09-01 | 234 |
| 2011: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 236 |
| Total of all active and inactive participants | 2011-09-01 | 236 |
| 2010: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-09-01 | 231 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 219 |
| Total of all active and inactive participants | 2010-09-01 | 219 |
| 2009: AMERI-NATIONAL CORPORATION BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 231 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 231 |
| Total of all active and inactive participants | 2009-09-01 | 231 |
| DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
| Policy contract number | 22840000 |
| Policy instance | 4 |
| Insurance contract or identification number | 22840000 | | Number of Individuals Covered | 853 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $281,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43013000 |
| Policy instance | 3 |
| Insurance contract or identification number | 43013000 | | Number of Individuals Covered | 842 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $89,051 | | Total amount of fees paid to insurance company | USD $52,343 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,452,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $89,051 | | Amount paid for insurance broker fees | 52343 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 603 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,965 | | Total amount of fees paid to insurance company | USD $86 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $198,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,965 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 86 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 0471723 | | Number of Individuals Covered | 669 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,077 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 0471723 | | Number of Individuals Covered | 680 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43013000 |
| Policy instance | 3 |
| Insurance contract or identification number | 43013000 | | Number of Individuals Covered | 871 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $78,746 | | Total amount of fees paid to insurance company | USD $46,799 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,828,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $78,746 | | Amount paid for insurance broker fees | 46799 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 633 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,742 | | Total amount of fees paid to insurance company | USD $84 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $187,120 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,742 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 84 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340066 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340066 | | Number of Individuals Covered | 752 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $294,194 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $10,020 | | Total amount of fees paid to insurance company | USD $80 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $168,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 70 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $10,020 |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43013000 |
| Policy instance | 3 |
| Insurance contract or identification number | 43013000 | | Number of Individuals Covered | 818 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $64,895 | | Total amount of fees paid to insurance company | USD $42,254 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,347,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,895 | | Amount paid for insurance broker fees | 42254 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 620 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,244 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340066 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340066 | | Number of Individuals Covered | 828 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $282,533 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 503 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340066 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340066 | | Number of Individuals Covered | 707 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $235,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43013000 |
| Policy instance | 3 |
| Insurance contract or identification number | 43013000 | | Number of Individuals Covered | 694 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $55,535 | | Total amount of fees paid to insurance company | USD $36,454 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,819,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,535 | | Amount paid for insurance broker fees | 36454 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES OTHER NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $129,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340066 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340066 | | Number of Individuals Covered | 552 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,109 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 43013000 |
| Policy instance | 3 |
| Insurance contract or identification number | 43013000 | | Number of Individuals Covered | 583 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $17,150 | | Total amount of fees paid to insurance company | USD $10,510 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $870,545 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,150 | | Amount paid for insurance broker fees | 10510 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 316 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $848 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $42,421 | | 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 organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 0471723 | | Number of Individuals Covered | 456 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $87 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 87 | | Additional information about fees paid to insurance broker | INDIRECT COMPENSATION | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 0471723 | | Number of Individuals Covered | 427 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of fees paid to insurance company | USD $58 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,571 | | 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 number | 908839 |
| Policy instance | 3 |
| Insurance contract or identification number | 908839 | | Number of Individuals Covered | 559 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $-31 | | Total amount of fees paid to insurance company | USD $58,260 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,274,795 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3340066 |
| Policy instance | 4 |
| Insurance contract or identification number | 3340066 | | Number of Individuals Covered | 588 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $200,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $6,609 | | Total amount of fees paid to insurance company | USD $106 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $114,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05918924 |
| Policy instance | 4 |
| Insurance contract or identification number | KM05918924 | | Number of Individuals Covered | 568 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $240 | | Total amount of fees paid to insurance company | USD $440 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $171,962 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $240 | | Amount paid for insurance broker fees | 440 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATION |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $3,901 | | Total amount of fees paid to insurance company | USD $89 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $98,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,901 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 89 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker name | AXA ASSISTANCE, USA |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 37005000 |
| Policy instance | 3 |
| Insurance contract or identification number | 37005000 | | Number of Individuals Covered | 434 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $27,285 | | Total amount of fees paid to insurance company | USD $21,822 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,605,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,285 | | Amount paid for insurance broker fees | 21822 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 0471723 | | Number of Individuals Covered | 326 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $154 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,786 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $154 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $3,079 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,842 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,079 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY AND ASSOCIATES INC |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $35,565 | | Total amount of fees paid to insurance company | USD $81 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $127,813 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,565 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 81 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker name | AXA ASSISTANCE, USA |
|
| BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
| Policy contract number | 37005000 |
| Policy instance | 3 |
| Insurance contract or identification number | 37005000 | | Number of Individuals Covered | 394 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,369,749 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05918924 |
| Policy instance | 4 |
| Insurance contract or identification number | KM05918924 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $3,976 | | Total amount of fees paid to insurance company | USD $3,959 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $145,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,976 | | Amount paid for insurance broker fees | 3959 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATION INC. |
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| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 2 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $30,038 | | Total amount of fees paid to insurance company | USD $83 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $126,862 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,038 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 83 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker name | AXA ASSISTANCE, USA |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 1 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 518 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $17,202 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,473,605 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,202 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY AND ASSOCIATES INC |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 5 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $30,194 | | Total amount of fees paid to insurance company | USD $85 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $125,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,194 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 85 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker name | AXA ASSISTANCE, USA |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00001 |
| Policy instance | 4 |
| Insurance contract or identification number | 52118-000-00001 | | Number of Individuals Covered | 180 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $15,838 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $154,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,838 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATES |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 3 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 326 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,346,726 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00003 |
| Policy instance | 2 |
| Insurance contract or identification number | 52118-000-00003 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $186 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,807 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $186 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATES |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00002 |
| Policy instance | 1 |
| Insurance contract or identification number | 52118-000-00002 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 52118-000-00001 |
| Policy instance | 6 |
| Insurance contract or identification number | 52118-000-00001 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $2,071 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,706 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,071 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLMES MURPHY & ASSOCIATES |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00002 |
| Policy instance | 1 |
| Insurance contract or identification number | 52118-000-00002 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00003 |
| Policy instance | 2 |
| Insurance contract or identification number | 52118-000-00003 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $167 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 3 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 334 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $1,162 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,341,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
| Policy contract number | 52118-000-00001 |
| Policy instance | 4 |
| Insurance contract or identification number | 52118-000-00001 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $14,270 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $142,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
| Policy contract number | 52118-000-00001 |
| Policy instance | 6 |
| Insurance contract or identification number | 52118-000-00001 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $1,975 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,746 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11597 |
| Policy instance | 5 |
| Insurance contract or identification number | 11597 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $30,058 | | Total amount of fees paid to insurance company | USD $77 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $120,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010129945 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010129945 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $7,487 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
| Policy contract number | 545103 |
| Policy instance | 2 |
| Insurance contract or identification number | 545103 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $1,753 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 471723 |
| Policy instance | 3 |
| Insurance contract or identification number | 471723 | | Number of Individuals Covered | 371 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $14,365 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,456,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010129944 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010129944 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $10,160 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $40,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 40000100011819 |
| Policy instance | 4 |
| Insurance contract or identification number | 40000100011819 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $8,772 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,898 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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