ST. MARY'S MEDICAL CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL
401k plan membership statisitcs for HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL
| Measure | Date | Value |
|---|
| 2022: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 2,694 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 2,565 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 21 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 2,586 |
| 2021: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2,417 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 2,673 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 22 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 2,695 |
| 2020: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 2,991 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 2,392 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 2,392 |
| 2019: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 2,965 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 2,991 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 2,991 |
| 2018: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 2,578 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 2,965 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 2,965 |
| 2017: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 2,383 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 2,346 |
| Total of all active and inactive participants | 2017-04-01 | 2,346 |
| 2016: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 2,359 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 2,399 |
| Total of all active and inactive participants | 2016-04-01 | 2,399 |
| 2015: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 2,379 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 2,349 |
| Total of all active and inactive participants | 2015-04-01 | 2,349 |
| 2014: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 2,256 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 2,305 |
| Total of all active and inactive participants | 2014-04-01 | 2,305 |
| 2013: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 2,293 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 2,232 |
| Total of all active and inactive participants | 2013-04-01 | 2,232 |
| 2012: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 2,192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 2,275 |
| Number of retired or separated participants receiving benefits | 2012-04-01 | 12 |
| Total of all active and inactive participants | 2012-04-01 | 2,287 |
| 2011: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 2,092 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 2,210 |
| Total of all active and inactive participants | 2011-04-01 | 2,210 |
| 2009: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 2,105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 2,166 |
| Number of retired or separated participants receiving benefits | 2009-04-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2009-04-01 | 0 |
| Total of all active and inactive participants | 2009-04-01 | 2,174 |
| 2008: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-04-01 | 1,977 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-04-01 | 2,101 |
| Number of retired or separated participants receiving benefits | 2008-04-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2008-04-01 | 0 |
| Total of all active and inactive participants | 2008-04-01 | 2,105 |
| 2022: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Submission has been amended | No |
| 2009-04-01 | This submission is the final filing | No |
| 2009-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-04-01 | Plan is a collectively bargained plan | No |
| 2009-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: HOSPITALIZATION PLAN FOR EMPLOYEES OF ST. MARY'S HOSPITAL 2008 form 5500 responses |
|---|
| 2008-04-01 | Type of plan entity | Single employer plan |
| 2008-04-01 | Submission has been amended | No |
| 2008-04-01 | This submission is the final filing | No |
| 2008-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-04-01 | Plan is a collectively bargained plan | No |
| 2008-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0212712 |
| Policy instance | 6 |
| Insurance contract or identification number | R0212712 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $554 | | Other welfare benefits provided | GCIEE, GRPACCVO | | Welfare Benefit Premiums Paid to Carrier | USD $6,461 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $277 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0008655403 |
| Policy instance | 5 |
| Insurance contract or identification number | 0008655403 | | Number of Individuals Covered | 2354 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $75,510 | | Total amount of fees paid to insurance company | USD $6,144 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $588,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,332 | | Amount paid for insurance broker fees | 3157 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000026060 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000026060 | | Number of Individuals Covered | 1834 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $145,994 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CI, AND HI | | Welfare Benefit Premiums Paid to Carrier | USD $696,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $73,650 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000118499 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000118499 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $212 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,676 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $212 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 53418 |
| Policy instance | 2 |
| Insurance contract or identification number | 53418 | | Number of Individuals Covered | 4076 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $149,742 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,059,968 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,004 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0166496 |
| Policy instance | 1 |
| Insurance contract or identification number | 0166496 | | Number of Individuals Covered | 4460 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $31,076 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,705,601 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 31076 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0166496 |
| Policy instance | 1 |
| Insurance contract or identification number | 0166496 | | Number of Individuals Covered | 5175 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $18,651 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,618,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 18651 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 53418 |
| Policy instance | 2 |
| Insurance contract or identification number | 53418 | | Number of Individuals Covered | 4196 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $83,901 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,014,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,919 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000118499 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000118499 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $273 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,394 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $273 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000026060 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000026060 | | Number of Individuals Covered | 3077 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $363,152 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CI, AND HI | | Welfare Benefit Premiums Paid to Carrier | USD $1,483,180 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $271,108 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0008655403 |
| Policy instance | 5 |
| Insurance contract or identification number | 0008655403 | | Number of Individuals Covered | 2723 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $178,373 | | Total amount of fees paid to insurance company | USD $19,700 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $594,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $87,658 | | Amount paid for insurance broker fees | 9850 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0212712 |
| Policy instance | 6 |
| Insurance contract or identification number | R0212712 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $692 | | Other welfare benefits provided | GCIEE, GRPACCVO | | Welfare Benefit Premiums Paid to Carrier | USD $7,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $346 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000026060 |
| Policy instance | 5 |
| Insurance contract or identification number | 0000026060 | | Number of Individuals Covered | 3720 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $623,092 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CI, AND HI | | Welfare Benefit Premiums Paid to Carrier | USD $1,339,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $313,236 | | Insurance broker organization code? | 3 |
|
| HIGHMARK WEST VIRGINIA (National Association of Insurance Commissioners NAIC id number: 54828 ) |
| Policy contract number | 090778 |
| Policy instance | 4 |
| Insurance contract or identification number | 090778 | | Number of Individuals Covered | 2677 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $51,068 | | Welfare Benefit Premiums Paid to Carrier | USD $1,232,580 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,068 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000118499 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000118499 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $69 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,856 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 53418 |
| Policy instance | 2 |
| Insurance contract or identification number | 53418 | | Number of Individuals Covered | 3957 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $77,640 | | Total amount of fees paid to insurance company | USD $5,600 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $964,272 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70,900 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5600 | | Additional information about fees paid to insurance broker | ENROLLMENT SERVICE FEES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0166496 |
| Policy instance | 1 |
| Insurance contract or identification number | 0166496 | | Number of Individuals Covered | 5399 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $604 | | Total amount of fees paid to insurance company | USD $14,377 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,459,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $604 | | Amount paid for insurance broker fees | 14377 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL/NON-MONETARY COMP. MARKETING FEES | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0166496 |
| Policy instance | 1 |
| Insurance contract or identification number | 0166496 | | Number of Individuals Covered | 5432 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $17,281 | | Total amount of fees paid to insurance company | USD $17,808 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,366,350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,281 | | Amount paid for insurance broker fees | 17808 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 79283 |
| Policy instance | 2 |
| Insurance contract or identification number | 79283 | | Number of Individuals Covered | 2991 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $71,962 | | Total amount of fees paid to insurance company | USD $14,250 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $713,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,962 | | Amount paid for insurance broker fees | 14250 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 53418 |
| Policy instance | 3 |
| Insurance contract or identification number | 53418 | | Number of Individuals Covered | 2145 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $19,892 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $198,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,892 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 402617G |
| Policy instance | 4 |
| Insurance contract or identification number | 402617G | | Number of Individuals Covered | 563 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $105,382 | | Total amount of fees paid to insurance company | USD $9,011 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $436,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,691 | | Amount paid for insurance broker fees | 9011 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
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| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0008655403 |
| Policy instance | 5 |
| Insurance contract or identification number | 0008655403 | | Number of Individuals Covered | 1650 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $76,478 | | Total amount of fees paid to insurance company | USD $10,252 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $354,746 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,133 | | Amount paid for insurance broker fees | 4094 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0008655403 |
| Policy instance | 6 |
| Insurance contract or identification number | 0008655403 | | Number of Individuals Covered | 2218 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $118,510 | | Total amount of fees paid to insurance company | USD $14,288 | | Other welfare benefits provided | GCIEE, GRPACCVO | | Welfare Benefit Premiums Paid to Carrier | USD $541,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $59,255 | | Amount paid for insurance broker fees | 7145 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
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| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000118499 |
| Policy instance | 7 |
| Insurance contract or identification number | 0000118499 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $190 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $190 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | 406957 0010SSLS |
| Policy instance | 8 |
| Insurance contract or identification number | 406957 0010SSLS | | Number of Individuals Covered | 2430 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $87,719 | | Welfare Benefit Premiums Paid to Carrier | USD $877,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,955 | | Insurance broker organization code? | 3 |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 402617G |
| Policy instance | 4 |
| Insurance contract or identification number | 402617G | | Number of Individuals Covered | 578 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $95,778 | | Total amount of fees paid to insurance company | USD $5,792 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $367,809 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,889 | | Amount paid for insurance broker fees | 5792 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 215783 0003 |
| Policy instance | 3 |
| Insurance contract or identification number | 215783 0003 | | Number of Individuals Covered | 2005 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $19,034 | | Total amount of fees paid to insurance company | USD $36,465 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $198,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,034 | | Amount paid for insurance broker fees | 36465 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 79283 |
| Policy instance | 2 |
| Insurance contract or identification number | 79283 | | Number of Individuals Covered | 2965 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $72,682 | | Total amount of fees paid to insurance company | USD $13,398 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $700,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,580 | | Amount paid for insurance broker fees | 13398 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0166496 |
| Policy instance | 1 |
| Insurance contract or identification number | 0166496 | | Number of Individuals Covered | 5276 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $18,318 | | Total amount of fees paid to insurance company | USD $29,959 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,268,571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,318 | | Amount paid for insurance broker fees | 29959 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
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