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QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameQC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

QC HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:QC HOLDINGS, INC.
Employer identification number (EIN):481209939
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Additional information about QC HOLDINGS, INC.

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 2016-12-28
Company Identification Number: 127835999
Legal Registered Office Address: 1600 PIONEER TOWER

PORTLAND
United States of America (USA)
97204

More information about QC HOLDINGS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-06-01DALE LONG2024-01-05
5012021-06-01
5012020-06-01
5012019-06-01
5012018-06-01
5012017-06-01KIEYATA WALROD
5012016-06-01KIEYATA WALROD
5012015-06-01KIEYATA WALROD
5012015-06-01KIEYATA WALROD
5012014-06-01KIEYATA WALROD
5012013-06-01KIEYATA WALROD
5012012-06-01KIEYATA WALROD
5012011-06-01KIEYATA WALROD
5012010-06-01KIEYATA WALROD
5012009-06-01KIEYATA WALROD

Plan Statistics for QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-06-01542
Total number of active participants reported on line 7a of the Form 55002022-06-01523
Number of retired or separated participants receiving benefits2022-06-011
Number of other retired or separated participants entitled to future benefits2022-06-010
Total of all active and inactive participants2022-06-01524
Number of employers contributing to the scheme2022-06-010
2021: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01545
Total number of active participants reported on line 7a of the Form 55002021-06-01540
Number of retired or separated participants receiving benefits2021-06-012
Number of other retired or separated participants entitled to future benefits2021-06-010
Total of all active and inactive participants2021-06-01542
2020: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01701
Total number of active participants reported on line 7a of the Form 55002020-06-01541
Number of retired or separated participants receiving benefits2020-06-014
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01545
2019: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01730
Total number of active participants reported on line 7a of the Form 55002019-06-01698
Number of retired or separated participants receiving benefits2019-06-013
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01701
2018: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01758
Total number of active participants reported on line 7a of the Form 55002018-06-01728
Number of retired or separated participants receiving benefits2018-06-011
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01729
2017: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-011,013
Total number of active participants reported on line 7a of the Form 55002017-06-01758
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01758
2016: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-011,065
Total number of active participants reported on line 7a of the Form 55002016-06-011,013
Number of retired or separated participants receiving benefits2016-06-010
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-011,013
2015: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-011,162
Total number of active participants reported on line 7a of the Form 55002015-06-01713
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01713
2014: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-011,261
Total number of active participants reported on line 7a of the Form 55002014-06-011,162
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-011,162
2013: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-011,261
Total number of active participants reported on line 7a of the Form 55002013-06-011,261
Total of all active and inactive participants2013-06-011,261
2012: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-011,389
Total number of active participants reported on line 7a of the Form 55002012-06-011,261
Total of all active and inactive participants2012-06-011,261
2011: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-01950
Total number of active participants reported on line 7a of the Form 55002011-06-01882
Total of all active and inactive participants2011-06-01882
2010: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-011,075
Total number of active participants reported on line 7a of the Form 55002010-06-01950
Total of all active and inactive participants2010-06-01950
2009: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-011,129
Total number of active participants reported on line 7a of the Form 55002009-06-011,075
Total of all active and inactive participants2009-06-011,075

Form 5500 Responses for QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN

2022: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-06-01Type of plan entitySingle employer plan
2022-06-01Plan funding arrangement – InsuranceYes
2022-06-01Plan funding arrangement – General assets of the sponsorYes
2022-06-01Plan benefit arrangement – InsuranceYes
2022-06-01Plan benefit arrangement – General assets of the sponsorYes
2021: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan funding arrangement – General assets of the sponsorYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – General assets of the sponsorYes
2020: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan funding arrangement – General assets of the sponsorYes
2020-06-01Plan benefit arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – General assets of the sponsorYes
2019: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan funding arrangement – General assets of the sponsorYes
2019-06-01Plan benefit arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – General assets of the sponsorYes
2018: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan funding arrangement – General assets of the sponsorYes
2018-06-01Plan benefit arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – General assets of the sponsorYes
2017: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan funding arrangement – General assets of the sponsorYes
2017-06-01Plan benefit arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – General assets of the sponsorYes
2016: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan funding arrangement – General assets of the sponsorYes
2016-06-01Plan benefit arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – General assets of the sponsorYes
2015: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedYes
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – General assets of the sponsorYes
2014: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – General assets of the sponsorYes
2013: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan funding arrangement – General assets of the sponsorYes
2013-06-01Plan benefit arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – General assets of the sponsorYes
2012: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan funding arrangement – General assets of the sponsorYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – General assets of the sponsorYes
2011: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan funding arrangement – General assets of the sponsorYes
2011-06-01Plan benefit arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – General assets of the sponsorYes
2010: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Submission has been amendedYes
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan funding arrangement – General assets of the sponsorYes
2010-06-01Plan benefit arrangement – InsuranceYes
2010-06-01Plan benefit arrangement – General assets of the sponsorYes
2009: QC HOLDINGS, INC. COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 3
Insurance contract or identification number50723
Number of Individuals Covered373
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $16,641
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $16,641
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 2
Insurance contract or identification number22977000
Number of Individuals Covered513
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $77,454
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees77454
Additional information about fees paid to insurance brokerPROVISION OF ADMINISTRATIVE SERVICES TO BCBSKC, NON-MONETARY COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 1
Insurance contract or identification number12310850
Number of Individuals Covered358
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $4,291
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,291
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL138837
Policy instance 4
Insurance contract or identification numberGL138837
Number of Individuals Covered523
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $22,828
Total amount of fees paid to insurance companyUSD $3,593
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT,CRITICAL ILLNESS,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $163,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,828
Amount paid for insurance broker fees3593
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered540
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $6,886
Total amount of fees paid to insurance companyUSD $1,814
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $68,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,886
Amount paid for insurance broker fees1814
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered372
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $15,038
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,038
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered98
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $2,142
Total amount of fees paid to insurance companyUSD $541
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,142
Amount paid for insurance broker fees541
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered365
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $3,750
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,750
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered148
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $8,188
Total amount of fees paid to insurance companyUSD $964
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $40,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,188
Amount paid for insurance broker fees964
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered168
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $3,851
Total amount of fees paid to insurance companyUSD $583
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $19,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,851
Amount paid for insurance broker fees583
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered532
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $95,830
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees95830
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered552
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $54,171
Total amount of fees paid to insurance companyUSD $89,952
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,171
Amount paid for insurance broker fees89952
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered450
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $18,492
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,492
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered122
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $2,050
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,050
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered717
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $7,265
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $72,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,265
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered349
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $4,253
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,253
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered134
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $8,018
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $40,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,018
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered211
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $4,845
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $24,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,845
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered34
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $6,825
Total amount of fees paid to insurance companyUSD $462
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $34,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,825
Amount paid for insurance broker fees462
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered432
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,509
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,509
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered698
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $8,197
Total amount of fees paid to insurance companyUSD $1,057
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,197
Amount paid for insurance broker fees1057
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered117
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $2,557
Total amount of fees paid to insurance companyUSD $318
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,557
Amount paid for insurance broker fees318
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered450
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $18,649
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,649
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered648
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $86,088
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees86088
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered205
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $5,815
Total amount of fees paid to insurance companyUSD $375
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $29,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,815
Amount paid for insurance broker fees375
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered678
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $85,405
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees85405
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered128
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $5,647
Total amount of fees paid to insurance companyUSD $309
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $28,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,647
Amount paid for insurance broker fees309
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered123
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $7,596
Total amount of fees paid to insurance companyUSD $470
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $37,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,596
Amount paid for insurance broker fees470
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered413
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $4,584
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,584
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered728
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $8,621
Total amount of fees paid to insurance companyUSD $1,099
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $86,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,621
Amount paid for insurance broker fees1099
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered115
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $2,467
Total amount of fees paid to insurance companyUSD $308
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,467
Amount paid for insurance broker fees308
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered453
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $18,794
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,794
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered140
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $4,211
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $21,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered109
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $7,471
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $37,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered412
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $4,796
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered758
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $9,088
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $90,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered112
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $2,426
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,263
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 number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered458
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $18,866
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,803
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 number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered698
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $91,327
Health Insurance Welfare BenefitYes
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 number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1161
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $104,930
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees104930
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered5
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $2,327
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,327
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered246
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $12,557
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $125,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,557
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered610
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $7,173
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,173
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAI 825527
Policy instance 6
Insurance contract or identification numberVAI 825527
Number of Individuals Covered95
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $4,313
Total amount of fees paid to insurance companyUSD $492
Other welfare benefits providedVOLUNTARY ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $21,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,313
Amount paid for insurance broker fees492
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVCI 800497
Policy instance 7
Insurance contract or identification numberVCI 800497
Number of Individuals Covered185
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $4,220
Total amount of fees paid to insurance companyUSD $485
Other welfare benefits providedVOLUNTARY CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $21,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,220
Amount paid for insurance broker fees485
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered681
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $30,236
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $266,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,236
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1161
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $109,096
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees109096
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered745
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $29,712
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $282,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,712
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered118
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $1,883
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,883
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered1162
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $13,877
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $139,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,877
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered659
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $7,535
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,535
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered681
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $7,882
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,882
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered118
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $2,478
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,478
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered785
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $33,052
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $297,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,052
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1164
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $45,837
Total amount of fees paid to insurance companyUSD $131,493
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,837
Amount paid for insurance broker fees131493
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered1261
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $14,274
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $142,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,274
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered1261
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $15,542
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $155,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,542
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )
Policy contract number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1298
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $119,750
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,004
Amount paid for insurance broker fees119750
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered118
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $2,844
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,844
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered798
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $35,026
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,026
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered690
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $8,129
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,129
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered912
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $33,789
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $328,669
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 number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1458
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $121,081
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered775
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $8,617
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered1389
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $15,917
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $159,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered129
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $2,851
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 112769
Policy instance 3
Insurance contract or identification numberLTD 112769
Number of Individuals Covered133
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $2,856
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,557
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 number50723
Policy instance 2
Insurance contract or identification number50723
Number of Individuals Covered943
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $33,410
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $320,015
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 number22977000
Policy instance 1
Insurance contract or identification number22977000
Number of Individuals Covered1485
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $50,004
Total amount of fees paid to insurance companyUSD $132,499
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12310850
Policy instance 5
Insurance contract or identification number12310850
Number of Individuals Covered815
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $8,967
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 138837
Policy instance 4
Insurance contract or identification numberGL 138837
Number of Individuals Covered1465
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $16,311
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $163,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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