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FUTURE TECHNOLOGIES, INC. - MEDICAL 401k Plan overview

Plan NameFUTURE TECHNOLOGIES, INC. - MEDICAL
Plan identification number 501

FUTURE TECHNOLOGIES, INC. - MEDICAL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

FUTURE TECHNOLOGIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:FUTURE TECHNOLOGIES, INC.
Employer identification number (EIN):541646962
NAIC Classification:517000

Additional information about FUTURE TECHNOLOGIES, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1992-12-23
Company Identification Number: 0402545
Legal Registered Office Address: 12600 FAIR LAKES CIRCLE

FARIFAX
United States of America (USA)
22033

More information about FUTURE TECHNOLOGIES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FUTURE TECHNOLOGIES, INC. - MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01ERIN BONESTEEL ERIN BONESTEEL2019-07-01
5012017-04-01MAEY SALAZAR
5012016-04-01JAY KASI
5012015-04-01JAY KASI
5012014-04-01JAY KASI
5012013-04-01MAEY SALAZAR
5012012-03-01JAY KASI
5012011-03-01JAY KASI
5012009-02-01JAY KASI
5012008-02-01JAY KASI
5012007-02-01JAY KASI

Plan Statistics for FUTURE TECHNOLOGIES, INC. - MEDICAL

401k plan membership statisitcs for FUTURE TECHNOLOGIES, INC. - MEDICAL

Measure Date Value
2022: FUTURE TECHNOLOGIES, INC. - MEDICAL 2022 401k membership
Total participants, beginning-of-year2022-04-0197
Total number of active participants reported on line 7a of the Form 55002022-04-01114
Total of all active and inactive participants2022-04-01114
Total participants2022-04-01114
2021: FUTURE TECHNOLOGIES, INC. - MEDICAL 2021 401k membership
Total participants, beginning-of-year2021-04-01102
Total number of active participants reported on line 7a of the Form 55002021-04-0197
Total of all active and inactive participants2021-04-0197
Total participants2021-04-0197
2020: FUTURE TECHNOLOGIES, INC. - MEDICAL 2020 401k membership
Total participants, beginning-of-year2020-04-01104
Total number of active participants reported on line 7a of the Form 55002020-04-01102
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01102
Total participants2020-04-01102
2019: FUTURE TECHNOLOGIES, INC. - MEDICAL 2019 401k membership
Total participants, beginning-of-year2019-04-01115
Total number of active participants reported on line 7a of the Form 55002019-04-01104
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01104
Total participants2019-04-01104
2018: FUTURE TECHNOLOGIES, INC. - MEDICAL 2018 401k membership
Total participants, beginning-of-year2018-04-01114
Total number of active participants reported on line 7a of the Form 55002018-04-01115
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01115
Total participants2018-04-01115
2017: FUTURE TECHNOLOGIES, INC. - MEDICAL 2017 401k membership
Total participants, beginning-of-year2017-04-01104
Total number of active participants reported on line 7a of the Form 55002017-04-010
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-01114
Total of all active and inactive participants2017-04-01114
Total participants2017-04-01114
2016: FUTURE TECHNOLOGIES, INC. - MEDICAL 2016 401k membership
Total participants, beginning-of-year2016-04-01108
Total number of active participants reported on line 7a of the Form 55002016-04-01104
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01104
Total participants2016-04-01104
2015: FUTURE TECHNOLOGIES, INC. - MEDICAL 2015 401k membership
Total participants, beginning-of-year2015-04-01260
Total number of active participants reported on line 7a of the Form 55002015-04-01108
Total of all active and inactive participants2015-04-01108
Total participants2015-04-01108
2014: FUTURE TECHNOLOGIES, INC. - MEDICAL 2014 401k membership
Total participants, beginning-of-year2014-04-01239
Total number of active participants reported on line 7a of the Form 55002014-04-01260
Total of all active and inactive participants2014-04-01260
Total participants2014-04-01260
2013: FUTURE TECHNOLOGIES, INC. - MEDICAL 2013 401k membership
Total participants, beginning-of-year2013-04-01129
Total number of active participants reported on line 7a of the Form 55002013-04-01239
Total of all active and inactive participants2013-04-01239
Total participants2013-04-01239
2012: FUTURE TECHNOLOGIES, INC. - MEDICAL 2012 401k membership
Total participants, beginning-of-year2012-03-0184
Total number of active participants reported on line 7a of the Form 55002012-03-0184
Total of all active and inactive participants2012-03-0184
Total participants2012-03-0184
2011: FUTURE TECHNOLOGIES, INC. - MEDICAL 2011 401k membership
Total participants, beginning-of-year2011-03-0192
Total number of active participants reported on line 7a of the Form 55002011-03-0192
Total of all active and inactive participants2011-03-0192
Total participants2011-03-0192
2009: FUTURE TECHNOLOGIES, INC. - MEDICAL 2009 401k membership
Total participants, beginning-of-year2009-02-01105
Total number of active participants reported on line 7a of the Form 55002009-02-01105
Total of all active and inactive participants2009-02-01105
Total participants2009-02-01105
2008: FUTURE TECHNOLOGIES, INC. - MEDICAL 2008 401k membership
Total participants, beginning-of-year2008-02-01103
Total number of active participants reported on line 7a of the Form 55002008-02-01103
Total of all active and inactive participants2008-02-01103
Total participants2008-02-01103
2007: FUTURE TECHNOLOGIES, INC. - MEDICAL 2007 401k membership
Total participants, beginning-of-year2007-02-01111
Total number of active participants reported on line 7a of the Form 55002007-02-01111
Total of all active and inactive participants2007-02-01111
Total participants2007-02-01111

Form 5500 Responses for FUTURE TECHNOLOGIES, INC. - MEDICAL

2022: FUTURE TECHNOLOGIES, INC. - MEDICAL 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: FUTURE TECHNOLOGIES, INC. - MEDICAL 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: FUTURE TECHNOLOGIES, INC. - MEDICAL 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: FUTURE TECHNOLOGIES, INC. - MEDICAL 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: FUTURE TECHNOLOGIES, INC. - MEDICAL 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01First time form 5500 has been submittedYes
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: FUTURE TECHNOLOGIES, INC. - MEDICAL 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01First time form 5500 has been submittedYes
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: FUTURE TECHNOLOGIES, INC. - MEDICAL 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01First time form 5500 has been submittedYes
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: FUTURE TECHNOLOGIES, INC. - MEDICAL 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01First time form 5500 has been submittedYes
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: FUTURE TECHNOLOGIES, INC. - MEDICAL 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01First time form 5500 has been submittedYes
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: FUTURE TECHNOLOGIES, INC. - MEDICAL 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01First time form 5500 has been submittedYes
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: FUTURE TECHNOLOGIES, INC. - MEDICAL 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01First time form 5500 has been submittedYes
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: FUTURE TECHNOLOGIES, INC. - MEDICAL 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01First time form 5500 has been submittedYes
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2009: FUTURE TECHNOLOGIES, INC. - MEDICAL 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01First time form 5500 has been submittedYes
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – InsuranceYes
2008: FUTURE TECHNOLOGIES, INC. - MEDICAL 2008 form 5500 responses
2008-02-01Type of plan entitySingle employer plan
2008-02-01First time form 5500 has been submittedYes
2008-02-01Submission has been amendedNo
2008-02-01This submission is the final filingNo
2008-02-01This return/report is a short plan year return/report (less than 12 months)No
2008-02-01Plan is a collectively bargained planNo
2008-02-01Plan funding arrangement – InsuranceYes
2008-02-01Plan benefit arrangement – InsuranceYes
2007: FUTURE TECHNOLOGIES, INC. - MEDICAL 2007 form 5500 responses
2007-02-01Type of plan entitySingle employer plan
2007-02-01First time form 5500 has been submittedYes
2007-02-01Submission has been amendedNo
2007-02-01This submission is the final filingNo
2007-02-01This return/report is a short plan year return/report (less than 12 months)No
2007-02-01Plan is a collectively bargained planNo
2007-02-01Plan funding arrangement – InsuranceYes
2007-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number081355
Policy instance 1
Insurance contract or identification number081355
Number of Individuals Covered114
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $26,100
Total amount of fees paid to insurance companyUSD $5,873
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,531,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,100
Amount paid for insurance broker fees5873
Insurance broker organization code?5
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number081355
Policy instance 1
Insurance contract or identification number081355
Number of Individuals Covered97
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $24,040
Total amount of fees paid to insurance companyUSD $5,409
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,546,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,040
Amount paid for insurance broker fees5409
Insurance broker organization code?5
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number081355
Policy instance 1
Insurance contract or identification number081355
Number of Individuals Covered102
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $24,160
Total amount of fees paid to insurance companyUSD $6,066
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,519,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,160
Amount paid for insurance broker fees6066
Insurance broker organization code?5
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number081355
Policy instance 1
Insurance contract or identification number081355
Number of Individuals Covered104
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $28,740
Total amount of fees paid to insurance companyUSD $6,467
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,067,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,740
Amount paid for insurance broker fees6467
Insurance broker organization code?3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number81355
Policy instance 1
Insurance contract or identification number81355
Number of Individuals Covered115
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $14,424
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,924,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,424
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number81355
Policy instance 1
Insurance contract or identification number81355
Number of Individuals Covered114
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $36,750
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,763,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,750
Amount paid for insurance broker fees0
Insurance broker organization code?5
Insurance broker nameEMPLOYEE BENEFITS CORP OF AMERICA
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3338835
Policy instance 1
Insurance contract or identification number3338835
Number of Individuals Covered108
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $49,429
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,412,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees49429
Insurance broker organization code?3
Insurance broker nameFOSTERTHOMAS, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number81355
Policy instance 1
Insurance contract or identification number81355
Number of Individuals Covered260
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $38,350
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,408,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees38350
Insurance broker organization code?3
Insurance broker nameEMPLOYEE BENEFITS CORPORATION OF AM
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number754246
Policy instance 1
Insurance contract or identification number754246
Number of Individuals Covered239
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $55,371
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $985,299
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 fees55371
Insurance broker organization code?3
Insurance broker nameTHOMAS G BEDARD
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3334522
Policy instance 1
Insurance contract or identification number3334522
Number of Individuals Covered84
Insurance policy start date2012-03-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $265
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,752
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3334522
Policy instance 1
Insurance contract or identification number3334522
Number of Individuals Covered92
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $48,115
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $962,304
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number81355
Policy instance 1
Insurance contract or identification number81355
Number of Individuals Covered122
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $40,820
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,103,245
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number26634
Policy instance 1
Insurance contract or identification number26634
Number of Individuals Covered103
Insurance policy start date2008-02-01
Insurance policy end date2009-01-31
Total amount of commissions paid to insurance brokerUSD $28,550
Total amount of fees paid to insurance companyUSD $259
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $771,314
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number26634
Policy instance 1
Insurance contract or identification number26634
Number of Individuals Covered111
Insurance policy start date2007-02-01
Insurance policy end date2008-01-31
Total amount of commissions paid to insurance brokerUSD $33,175
Total amount of fees paid to insurance companyUSD $55
Health Insurance Welfare BenefitYes

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