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WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 401k Plan overview

Plan NameWHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN
Plan identification number 501

WHEELING & LAKE ERIE COMPANY HEALTH 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)
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WHEELING & LAKE ERIE RAILWAY COMPANY has sponsored the creation of one or more 401k plans.

Company Name:WHEELING & LAKE ERIE RAILWAY COMPANY
Employer identification number (EIN):541533727
NAIC Classification:482110
NAIC Description: Rail Transportation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01DARREN VAN WINKLE2023-12-07
5012021-07-01JOSEPH C. BURLEY2022-11-22
5012020-07-01JOSEPH C. BURLEY2022-01-26
5012019-07-01JOSEPH C. BURLEY2021-01-04
5012018-07-01JOSEPH C. BURLEY2020-02-03
5012017-07-01
5012016-07-01
5012015-07-01
5012014-07-01
5012013-07-01
5012013-06-01
5012012-06-01DONNA L. PHILLIPS
5012011-06-01MICHAEL D. MOKODEN
5012009-06-01KATHLEEN MORAN
5012009-06-01KATHLEEN MORAN

Plan Statistics for WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN

401k plan membership statisitcs for WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN

Measure Date Value
2022: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01409
Total number of active participants reported on line 7a of the Form 55002022-07-01433
Number of retired or separated participants receiving benefits2022-07-017
Total of all active and inactive participants2022-07-01440
2021: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01418
Total number of active participants reported on line 7a of the Form 55002021-07-01402
Number of retired or separated participants receiving benefits2021-07-017
Total of all active and inactive participants2021-07-01409
2020: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01420
Total number of active participants reported on line 7a of the Form 55002020-07-01414
Number of retired or separated participants receiving benefits2020-07-014
Total of all active and inactive participants2020-07-01418
2019: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01421
Total number of active participants reported on line 7a of the Form 55002019-07-01418
Number of retired or separated participants receiving benefits2019-07-012
Total of all active and inactive participants2019-07-01420
2018: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01416
Total number of active participants reported on line 7a of the Form 55002018-07-01418
Number of retired or separated participants receiving benefits2018-07-013
Total of all active and inactive participants2018-07-01421
2017: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01407
Total number of active participants reported on line 7a of the Form 55002017-07-01412
Number of retired or separated participants receiving benefits2017-07-014
Total of all active and inactive participants2017-07-01416
2016: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-011,319
Total number of active participants reported on line 7a of the Form 55002016-07-01404
Number of retired or separated participants receiving benefits2016-07-013
Total of all active and inactive participants2016-07-01407
2015: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-011,053
Total number of active participants reported on line 7a of the Form 55002015-07-011,319
Total of all active and inactive participants2015-07-011,319
2014: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01940
Total number of active participants reported on line 7a of the Form 55002014-07-011,053
Total of all active and inactive participants2014-07-011,053
2013: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01332
Total number of active participants reported on line 7a of the Form 55002013-07-01385
Total of all active and inactive participants2013-07-01385
Total participants, beginning-of-year2013-06-01316
Total number of active participants reported on line 7a of the Form 55002013-06-01332
Total of all active and inactive participants2013-06-01332
2012: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01316
Total number of active participants reported on line 7a of the Form 55002012-06-01339
Total of all active and inactive participants2012-06-01339
2011: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-01324
Total number of active participants reported on line 7a of the Form 55002011-06-01316
Total of all active and inactive participants2011-06-01316
2009: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-01358
Total number of active participants reported on line 7a of the Form 55002009-06-01346
Total of all active and inactive participants2009-06-01346

Form 5500 Responses for WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN

2022: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2013-06-01Type of plan entitySingle employer plan
2013-06-01This return/report is a short plan year return/report (less than 12 months)Yes
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: WHEELING & LAKE ERIE COMPANY HEALTH 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: WHEELING & LAKE ERIE COMPANY HEALTH 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
2009: WHEELING & LAKE ERIE COMPANY HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01This submission is the final filingNo
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

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered292
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $7,916
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $79,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,916
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered433
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $18,777
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $190,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,777
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number
Policy instance 1
Number of Individuals Covered365
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $36,648
Total amount of fees paid to insurance companyUSD $211,235
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees200742
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $36,648
Additional information about fees paid to insurance brokerWDI ADMIN
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered304
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $8,259
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $82,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,259
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered409
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $19,204
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $189,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,204
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number
Policy instance 1
Number of Individuals Covered383
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $37,080
Total amount of fees paid to insurance companyUSD $216,499
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees205894
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $37,080
Additional information about fees paid to insurance brokerWDI ADMIN
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number
Policy instance 1
Number of Individuals Covered397
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $38,648
Total amount of fees paid to insurance companyUSD $222,381
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability 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 $0
Amount paid for insurance broker fees211330
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered414
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $19,819
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $191,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,819
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered413
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $8,885
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $88,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,885
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered403
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $8,116
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $81,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,116
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered420
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $16,541
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $181,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,541
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number
Policy instance 1
Number of Individuals Covered413
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $39,360
Total amount of fees paid to insurance companyUSD $223,202
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees212018
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $39,360
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered402
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,151
Total amount of fees paid to insurance companyUSD $514
Welfare Benefit Premiums Paid to CarrierUSD $70,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,151
Amount paid for insurance broker fees514
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number
Policy instance 1
Number of Individuals Covered404
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $38,560
Total amount of fees paid to insurance companyUSD $219,500
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees208475
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $38,560
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered421
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $24,571
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $176,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,571
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered405
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $42,295
Total amount of fees paid to insurance companyUSD $212,049
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees201026
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $42,295
Insurance broker nameDENTEMAX
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015246
Policy instance 2
Insurance contract or identification numberF015246
Number of Individuals Covered416
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $7,761
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $175,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,761
Insurance broker organization code?3
Insurance broker nameANTHONY OLIVIERI III
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered406
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,008
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $74,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,008
Insurance broker organization code?3
Insurance broker nameTHE FEDELI GROUP, INC
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered396
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $51,984
Total amount of fees paid to insurance companyUSD $201,674
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $170,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees190836
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $51,984
Insurance broker nameDENTEMAX
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036589
Policy instance 2
Insurance contract or identification number1036589
Number of Individuals Covered1319
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $20,060
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,674
Insurance broker organization code?3
Insurance broker nameBUSINESS UNDERWRITERS ASSOC AGENCY
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered425
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $5,637
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $56,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,637
Insurance broker organization code?3
Insurance broker nameTHE FIDELI GROUP
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered407
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $50,352
Total amount of fees paid to insurance companyUSD $194,839
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $152,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees184484
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $50,352
Insurance broker nameDENTEMAX
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036589
Policy instance 2
Insurance contract or identification number1036589
Number of Individuals Covered1053
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $18,134
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $159,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,370
Insurance broker organization code?3
Insurance broker nameBUSINESS UNDERWRITERS ASSOC AGENCY
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239800
Policy instance 3
Insurance contract or identification number239800
Number of Individuals Covered572
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,730
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $57,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,730
Insurance broker organization code?3
Insurance broker nameTHE FEDELI GROUP
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036589
Policy instance 2
Insurance contract or identification number1036589
Number of Individuals Covered878
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $16,394
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,159
Insurance broker organization code?3
Amount paid for insurance broker fees0
Insurance broker nameBUSINESS UNDERWRITERS ASSOC AGENCY
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered385
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $44,330
Total amount of fees paid to insurance companyUSD $167,098
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $141,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees160353
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $44,330
Insurance broker nameCONSUMERS LIFE INSURANCE COMPANY
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered339
Insurance policy start date2013-06-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $3,222
Total amount of fees paid to insurance companyUSD $509
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,222
Amount paid for insurance broker fees509
Additional information about fees paid to insurance brokerACCESS FEES
Insurance broker organization code?3
Insurance broker nameTHE FEDELI GROUP
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered339
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $38,662
Total amount of fees paid to insurance companyUSD $6,107
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $112,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,662
Amount paid for insurance broker fees6107
Additional information about fees paid to insurance brokerACCESS FEES
Insurance broker organization code?3
Insurance broker nameTHE FEDELI GROUP
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered316
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $30,272
Total amount of fees paid to insurance companyUSD $65,382
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $115,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number
Policy instance 1
Number of Individuals Covered324
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $30,272
Total amount of fees paid to insurance companyUSD $65,382
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $115,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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