LERNER CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852
401k plan membership statisitcs for LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852
| Measure | Date | Value |
|---|
| 2022: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-12-01 | 330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-12-01 | 325 |
| Number of retired or separated participants receiving benefits | 2022-12-01 | 5 |
| Total of all active and inactive participants | 2022-12-01 | 330 |
| 2021: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-01 | 327 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 329 |
| Number of retired or separated participants receiving benefits | 2021-12-01 | 1 |
| Total of all active and inactive participants | 2021-12-01 | 330 |
| 2020: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 368 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 325 |
| Number of retired or separated participants receiving benefits | 2020-12-01 | 2 |
| Total of all active and inactive participants | 2020-12-01 | 327 |
| 2019: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 525 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 521 |
| Number of retired or separated participants receiving benefits | 2019-12-01 | 4 |
| Total of all active and inactive participants | 2019-12-01 | 525 |
| 2018: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 545 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 522 |
| Number of retired or separated participants receiving benefits | 2018-12-01 | 3 |
| Total of all active and inactive participants | 2018-12-01 | 525 |
| 2017: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 542 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 544 |
| Number of retired or separated participants receiving benefits | 2017-12-01 | 1 |
| Total of all active and inactive participants | 2017-12-01 | 545 |
| 2016: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-01 | 562 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 542 |
| Number of retired or separated participants receiving benefits | 2016-12-01 | 4 |
| Total of all active and inactive participants | 2016-12-01 | 546 |
| 2015: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-01 | 520 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 558 |
| Number of retired or separated participants receiving benefits | 2015-12-01 | 4 |
| Total of all active and inactive participants | 2015-12-01 | 562 |
| 2014: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 497 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 517 |
| Number of retired or separated participants receiving benefits | 2014-12-01 | 3 |
| Total of all active and inactive participants | 2014-12-01 | 520 |
| 2013: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-12-01 | 474 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-12-01 | 495 |
| Number of retired or separated participants receiving benefits | 2013-12-01 | 2 |
| Total of all active and inactive participants | 2013-12-01 | 497 |
| 2012: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-12-01 | 457 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-12-01 | 469 |
| Number of retired or separated participants receiving benefits | 2012-12-01 | 5 |
| Total of all active and inactive participants | 2012-12-01 | 474 |
| 2011: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-12-01 | 454 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 457 |
| Number of retired or separated participants receiving benefits | 2011-12-01 | 17 |
| Total of all active and inactive participants | 2011-12-01 | 474 |
| 2009: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-12-01 | 447 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 445 |
| Number of retired or separated participants receiving benefits | 2009-12-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2009-12-01 | 17 |
| Total of all active and inactive participants | 2009-12-01 | 468 |
| 2022: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2022 form 5500 responses |
|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2021 form 5500 responses |
|---|
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2020 form 5500 responses |
|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2019 form 5500 responses |
|---|
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2018 form 5500 responses |
|---|
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2017 form 5500 responses |
|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2016 form 5500 responses |
|---|
| 2016-12-01 | Type of plan entity | Single employer plan |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2015 form 5500 responses |
|---|
| 2015-12-01 | Type of plan entity | Single employer plan |
| 2015-12-01 | Plan funding arrangement – Insurance | Yes |
| 2015-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2014 form 5500 responses |
|---|
| 2014-12-01 | Type of plan entity | Single employer plan |
| 2014-12-01 | Plan funding arrangement – Insurance | Yes |
| 2014-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2013 form 5500 responses |
|---|
| 2013-12-01 | Type of plan entity | Single employer plan |
| 2013-12-01 | Plan funding arrangement – Insurance | Yes |
| 2013-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2012 form 5500 responses |
|---|
| 2012-12-01 | Type of plan entity | Single employer plan |
| 2012-12-01 | Plan funding arrangement – Insurance | Yes |
| 2012-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2011 form 5500 responses |
|---|
| 2011-12-01 | Type of plan entity | Single employer plan |
| 2011-12-01 | Plan funding arrangement – Insurance | Yes |
| 2011-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2009 form 5500 responses |
|---|
| 2009-12-01 | Type of plan entity | Single employer plan |
| 2009-12-01 | This submission is the final filing | No |
| 2009-12-01 | Plan funding arrangement – Insurance | Yes |
| 2009-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: LERNER CORPORATION GROUP INSURANCE PLAN 2000 TOWER OAKS BLVD ROCKVILLE, MD 20852 2008 form 5500 responses |
|---|
| 2008-12-01 | Type of plan entity | Single employer plan |
| 2008-12-01 | Submission has been amended | No |
| 2008-12-01 | This submission is the final filing | No |
| 2008-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-12-01 | Plan is a collectively bargained plan | No |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1155607 |
| Policy instance | 4 |
| Insurance contract or identification number | 1155607 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $8,409 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $163,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,409 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,184 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,184 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 2 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,457 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $113,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,457 | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 146010203,72,73 |
| Policy instance | 1 |
| Insurance contract or identification number | 146010203,72,73 | | Number of Individuals Covered | 471 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $97,832 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,916 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 4 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 329 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $5,121 | | Total amount of fees paid to insurance company | USD $8,202 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,062 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,121 | | Amount paid for insurance broker fees | 8202 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 5 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 324 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $3,749 | | Total amount of fees paid to insurance company | USD $3,470 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,749 | | Amount paid for insurance broker fees | 3470 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 146010203,72,73 |
| Policy instance | 1 |
| Insurance contract or identification number | 146010203,72,73 | | Number of Individuals Covered | 437 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $101,236 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,618 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 2 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,709 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,308 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,709 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,355 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,704 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,355 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 5 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 340 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of commissions paid to insurance broker | USD $3,970 | | Total amount of fees paid to insurance company | USD $1,825 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1825 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $3,970 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 4 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 338 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of commissions paid to insurance broker | USD $5,189 | | Total amount of fees paid to insurance company | USD $3,905 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,189 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3905 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,281 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,280 | | Insurance broker organization code? | 3 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 2 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,198 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,202 | | Insurance broker organization code? | 3 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 146010203,72,73 |
| Policy instance | 1 |
| Insurance contract or identification number | 146010203,72,73 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $108,086 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,044 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 5 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 368 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $4,025 | | Total amount of fees paid to insurance company | USD $1,201 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,990 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 4 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 363 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $5,100 | | Total amount of fees paid to insurance company | USD $2,500 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,331 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,508 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 2 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 293 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $5,961 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 146010203,72,73 |
| Policy instance | 1 |
| Insurance contract or identification number | 146010203,72,73 | | Number of Individuals Covered | 468 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $93,810 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 603991 |
| Policy instance | 2 |
| Insurance contract or identification number | 603991 | | Number of Individuals Covered | 424 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $2,540 | | Total amount of fees paid to insurance company | USD $317 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,296 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,540 | | Amount paid for insurance broker fees | 317 |
|
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 146010203,72,73 |
| Policy instance | 1 |
| Insurance contract or identification number | 146010203,72,73 | | Number of Individuals Covered | 525 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $95,998 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,999 |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 314 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $6,458 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $129,741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,458 |
|
| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 4 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,384 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,765 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,384 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 5 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 420 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $5,115 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $111,454 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,115 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000BBFY |
| Policy instance | 6 |
| Insurance contract or identification number | G000BBFY | | Number of Individuals Covered | 429 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $4,125 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,125 |
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| UNITED CONCORDIA DENTAL PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95253 ) |
| Policy contract number | 889179-000 -099 |
| Policy instance | 4 |
| Insurance contract or identification number | 889179-000 -099 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,756 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,437 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 889180-099 |
| Policy instance | 3 |
| Insurance contract or identification number | 889180-099 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,604 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $122,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 603991 |
| Policy instance | 2 |
| Insurance contract or identification number | 603991 | | Number of Individuals Covered | 464 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of commissions paid to insurance broker | USD $15,960 | | Total amount of fees paid to insurance company | USD $1,995 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $159,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
| Policy contract number | 1460101,02,71 |
| Policy instance | 1 |
| Insurance contract or identification number | 1460101,02,71 | | Number of Individuals Covered | 544 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $94,566 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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