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HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 401k Plan overview

Plan NameHEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD
Plan identification number 501

HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

DRAKE SOFTWARE LLC has sponsored the creation of one or more 401k plans.

Company Name:DRAKE SOFTWARE LLC
Employer identification number (EIN):561494243
NAIC Classification:541511
NAIC Description:Custom Computer Programming Services

Additional information about DRAKE SOFTWARE LLC

Jurisdiction of Incorporation: North Carolina Secretary of State
Incorporation Date:
Company Identification Number: 0175704

More information about DRAKE SOFTWARE LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MIKE MCFERRIN2023-10-11
5012021-01-01MIKE MCFERRIN2022-10-11
5012020-01-01PAUL MARTIN2021-09-27
5012019-01-01PAUL MARTIN2020-10-07
5012018-01-01PAUL MARTIN2019-07-17
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01PAUL MARTIN
5012011-01-01PAUL H. MARTIN
5012010-01-01PAUL MARTIN
5012009-01-01PAUL MARTIN

Plan Statistics for HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD

401k plan membership statisitcs for HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD

Measure Date Value
2022: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2022 401k membership
Total participants, beginning-of-year2022-01-0186
Total number of active participants reported on line 7a of the Form 55002022-01-0182
Total of all active and inactive participants2022-01-0182
2021: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2021 401k membership
Total participants, beginning-of-year2021-01-01608
Total number of active participants reported on line 7a of the Form 55002021-01-0186
Total of all active and inactive participants2021-01-0186
2020: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2020 401k membership
Total participants, beginning-of-year2020-01-01627
Total number of active participants reported on line 7a of the Form 55002020-01-01608
Total of all active and inactive participants2020-01-01608
2019: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2019 401k membership
Total participants, beginning-of-year2019-01-01587
Total number of active participants reported on line 7a of the Form 55002019-01-01627
Total of all active and inactive participants2019-01-01627
2018: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2018 401k membership
Total participants, beginning-of-year2018-01-01599
Total number of active participants reported on line 7a of the Form 55002018-01-01587
Total of all active and inactive participants2018-01-01587
2017: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2017 401k membership
Total participants, beginning-of-year2017-01-01596
Total number of active participants reported on line 7a of the Form 55002017-01-01599
Total of all active and inactive participants2017-01-01599
2016: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2016 401k membership
Total participants, beginning-of-year2016-01-01521
Total number of active participants reported on line 7a of the Form 55002016-01-01596
Total of all active and inactive participants2016-01-01596
Total participants2016-01-01596
2015: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2015 401k membership
Total participants, beginning-of-year2015-01-01414
Total number of active participants reported on line 7a of the Form 55002015-01-01521
Total of all active and inactive participants2015-01-01521
Total participants2015-01-01521
2014: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2014 401k membership
Total participants, beginning-of-year2014-01-01404
Total number of active participants reported on line 7a of the Form 55002014-01-01414
Total of all active and inactive participants2014-01-01414
Total participants2014-01-01414
2013: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2013 401k membership
Total participants, beginning-of-year2013-01-01396
Total number of active participants reported on line 7a of the Form 55002013-01-01404
Total of all active and inactive participants2013-01-01404
2012: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2012 401k membership
Total participants, beginning-of-year2012-01-01390
Total number of active participants reported on line 7a of the Form 55002012-01-01396
Total of all active and inactive participants2012-01-01396
2011: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2011 401k membership
Total participants, beginning-of-year2011-01-01360
Total number of active participants reported on line 7a of the Form 55002011-01-01390
Total of all active and inactive participants2011-01-01390
2010: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2010 401k membership
Total participants, beginning-of-year2010-01-01339
Total number of active participants reported on line 7a of the Form 55002010-01-01356
Number of retired or separated participants receiving benefits2010-01-014
Total of all active and inactive participants2010-01-01360
2009: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2009 401k membership
Total participants, beginning-of-year2009-01-01320
Total number of active participants reported on line 7a of the Form 55002009-01-01339
Total of all active and inactive participants2009-01-01339

Financial Data on HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD

Measure Date Value
2016 : HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2016 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No

Form 5500 Responses for HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD

2022: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: HEALTH CARE BENEFITS PLAN FOR THE EMPLOYEES OF DRA ENTERPRISES, LTD 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1153191
Policy instance 4
Insurance contract or identification number1153191
Number of Individuals Covered65
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,034
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,249
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1153191
Policy instance 3
Insurance contract or identification number1153191
Number of Individuals Covered54
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,165
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $434
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number141674271001
Policy instance 2
Insurance contract or identification number141674271001
Number of Individuals Covered82
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $28,084
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,126,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,084
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506019
Policy instance 1
Insurance contract or identification number00506019
Number of Individuals Covered41
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,586
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,049
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98978361001
Policy instance 3
Insurance contract or identification number98978361001
Number of Individuals Covered162
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,754
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,754
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number141674279001
Policy instance 2
Insurance contract or identification number141674279001
Number of Individuals Covered86
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506019
Policy instance 1
Insurance contract or identification number00506019
Number of Individuals Covered83
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $18,659
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,439
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98978361001
Policy instance 3
Insurance contract or identification number98978361001
Number of Individuals Covered898
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,575
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,575
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number081601
Policy instance 2
Insurance contract or identification number081601
Number of Individuals Covered608
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506019
Policy instance 1
Insurance contract or identification number00506019
Number of Individuals Covered550
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $46,160
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,804
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number98978361001
Policy instance 3
Insurance contract or identification number98978361001
Number of Individuals Covered876
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,670
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,670
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number081601
Policy instance 2
Insurance contract or identification number081601
Number of Individuals Covered627
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506019
Policy instance 1
Insurance contract or identification number00506019
Number of Individuals Covered627
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $32,497
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,497
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9897836
Policy instance 3
Insurance contract or identification number9897836
Number of Individuals Covered835
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,050
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,414
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number081601
Policy instance 2
Insurance contract or identification number081601
Number of Individuals Covered587
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00506019
Policy instance 1
Insurance contract or identification number00506019
Number of Individuals Covered632
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $32,983
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $329,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,983
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9897836
Policy instance 3
Insurance contract or identification number9897836
Number of Individuals Covered927
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,060
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,060
Insurance broker organization code?3
Insurance broker nameDIGITAL INS INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number081601
Policy instance 2
Insurance contract or identification number081601
Number of Individuals Covered599
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009N559
Policy instance 1
Insurance contract or identification number0009N559
Number of Individuals Covered619
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $41,728
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $417,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,728
Insurance broker organization code?3
Insurance broker nameDIGITAL INS INC

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