DORNIER MEDTECH AMERICA, INC. has sponsored the creation of one or more 401k plans.
Additional information about DORNIER MEDTECH AMERICA, INC.
Submission information for form 5500 for 401k plan DORNIER MEDTECH AMERICA, INC. HEALTH & WELFARE BENEFITS PLAN
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30054175 |
| Policy instance | 1 |
| Insurance contract or identification number | 30054175 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,448 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,378 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | CI962389 |
| Policy instance | 2 |
| Insurance contract or identification number | CI962389 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $245 | | Total amount of fees paid to insurance company | USD $92 | | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $1,226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 899328G |
| Policy instance | 3 |
| Insurance contract or identification number | 899328G | | Number of Individuals Covered | 128 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $18,079 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | WD-NST | | Welfare Benefit Premiums Paid to Carrier | USD $120,527 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00614961 |
| Policy instance | 4 |
| Insurance contract or identification number | 00614961 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $11,709 | | Total amount of fees paid to insurance company | USD $125,412 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,625,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | HC 962389 |
| Policy instance | 5 |
| Insurance contract or identification number | HC 962389 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $324 | | Total amount of fees paid to insurance company | USD $126 | | Other welfare benefits provided | VOLUNTARY HOSPITAL CARE | | Welfare Benefit Premiums Paid to Carrier | USD $1,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | AI962390 |
| Policy instance | 6 |
| Insurance contract or identification number | AI962390 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $194 | | Total amount of fees paid to insurance company | USD $77 | | Other welfare benefits provided | ACCIDENTAL INJURY | | Welfare Benefit Premiums Paid to Carrier | USD $970 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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