MEDAC, INC. has sponsored the creation of one or more 401k plans.
Additional information about MEDAC, INC.
| Measure | Date | Value |
|---|
| 2017: MEDAC INC MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 437 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 329 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 109 |
| Total of all active and inactive participants | 2017-01-01 | 438 |
| Total participants | 2017-01-01 | 438 |
| Number of employers contributing to the scheme | 2017-01-01 | 515 |
| 2016: MEDAC INC MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 320 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 437 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 438 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 1 |
| Total participants | 2016-01-01 | 439 |
| Number of participants with account balances | 2016-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
| Number of employers contributing to the scheme | 2016-01-01 | 508 |
| 2015: MEDAC INC MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 300 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 320 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 2 |
| Total of all active and inactive participants | 2015-01-01 | 322 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 322 |
| Number of participants with account balances | 2015-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
| 2013: MEDAC INC MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 270 |
| Total of all active and inactive participants | 2013-03-01 | 0 |
| Total participants | 2013-03-01 | 0 |
| 2010: MEDAC INC MEDICAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 200 |
| Total of all active and inactive participants | 2010-01-01 | 200 |
| Total participants | 2010-01-01 | 200 |
| Number of employers contributing to the scheme | 2010-01-01 | 200 |
| 2009: MEDAC INC MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 330 |
| Number of retired or separated participants receiving benefits | 2009-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-03-01 | 0 |
| Total of all active and inactive participants | 2009-03-01 | 330 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-03-01 | 0 |
| Total participants | 2009-03-01 | 330 |
| Number of participants with account balances | 2009-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-03-01 | 0 |
| Number of employers contributing to the scheme | 2009-03-01 | 330 |
| 2008: MEDAC INC MEDICAL PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-03-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-03-01 | 201 |
| Number of retired or separated participants receiving benefits | 2008-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-03-01 | 0 |
| Total of all active and inactive participants | 2008-03-01 | 201 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2008-03-01 | 0 |
| Total participants | 2008-03-01 | 201 |
| Number of participants with account balances | 2008-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2008-03-01 | 0 |
| Number of employers contributing to the scheme | 2008-03-01 | 201 |
| 2007: MEDAC INC MEDICAL PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-03-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-03-01 | 168 |
| Number of retired or separated participants receiving benefits | 2007-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-03-01 | 0 |
| Total of all active and inactive participants | 2007-03-01 | 168 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2007-03-01 | 0 |
| Total participants | 2007-03-01 | 168 |
| Number of participants with account balances | 2007-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2007-03-01 | 0 |
| Number of employers contributing to the scheme | 2007-03-01 | 168 |
| 2006: MEDAC INC MEDICAL PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-03-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-03-01 | 168 |
| Number of retired or separated participants receiving benefits | 2006-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-03-01 | 0 |
| Total of all active and inactive participants | 2006-03-01 | 168 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2006-03-01 | 0 |
| Total participants | 2006-03-01 | 168 |
| Number of participants with account balances | 2006-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2006-03-01 | 0 |
| Number of employers contributing to the scheme | 2006-03-01 | 168 |
| 2005: MEDAC INC MEDICAL PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-03-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-03-01 | 155 |
| Number of retired or separated participants receiving benefits | 2005-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-03-01 | 0 |
| Total of all active and inactive participants | 2005-03-01 | 155 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2005-03-01 | 0 |
| Total participants | 2005-03-01 | 155 |
| Number of participants with account balances | 2005-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2005-03-01 | 0 |
| Number of employers contributing to the scheme | 2005-03-01 | 155 |
| 2004: MEDAC INC MEDICAL PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-03-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-03-01 | 145 |
| Number of retired or separated participants receiving benefits | 2004-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-03-01 | 0 |
| Total of all active and inactive participants | 2004-03-01 | 145 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2004-03-01 | 0 |
| Total participants | 2004-03-01 | 145 |
| Number of participants with account balances | 2004-03-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2004-03-01 | 0 |
| Number of employers contributing to the scheme | 2004-03-01 | 145 |
| Total participants, beginning-of-year | 2004-01-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-01-01 | 106 |
| Total of all active and inactive participants | 2004-01-01 | 106 |
| Total participants | 2004-01-01 | 106 |
| Number of employers contributing to the scheme | 2004-01-01 | 106 |
| 2003: MEDAC INC MEDICAL PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-01-01 | 127 |
| Number of retired or separated participants receiving benefits | 2003-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-01-01 | 0 |
| Total of all active and inactive participants | 2003-01-01 | 127 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2003-01-01 | 0 |
| Total participants | 2003-01-01 | 127 |
| Number of participants with account balances | 2003-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2003-01-01 | 0 |
| Number of employers contributing to the scheme | 2003-01-01 | 127 |
| 2017: MEDAC INC MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: MEDAC INC MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | First time form 5500 has been submitted | Yes |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: MEDAC INC MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: MEDAC INC MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Submission has been amended | No |
| 2013-03-01 | This submission is the final filing | No |
| 2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-03-01 | Plan is a collectively bargained plan | No |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: MEDAC INC MEDICAL PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | First time form 5500 has been submitted | Yes |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: MEDAC INC MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | First time form 5500 has been submitted | Yes |
| 2009-03-01 | Submission has been amended | No |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-03-01 | Plan is a collectively bargained plan | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: MEDAC INC MEDICAL PLAN 2008 form 5500 responses |
|---|
| 2008-03-01 | Type of plan entity | Single employer plan |
| 2008-03-01 | First time form 5500 has been submitted | Yes |
| 2008-03-01 | Submission has been amended | No |
| 2008-03-01 | This submission is the final filing | No |
| 2008-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-03-01 | Plan is a collectively bargained plan | No |
| 2008-03-01 | Plan funding arrangement – Insurance | Yes |
| 2008-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: MEDAC INC MEDICAL PLAN 2007 form 5500 responses |
|---|
| 2007-03-01 | Type of plan entity | Single employer plan |
| 2007-03-01 | First time form 5500 has been submitted | Yes |
| 2007-03-01 | Submission has been amended | No |
| 2007-03-01 | This submission is the final filing | No |
| 2007-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-03-01 | Plan is a collectively bargained plan | No |
| 2007-03-01 | Plan funding arrangement – Insurance | Yes |
| 2007-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: MEDAC INC MEDICAL PLAN 2006 form 5500 responses |
|---|
| 2006-03-01 | Type of plan entity | Single employer plan |
| 2006-03-01 | First time form 5500 has been submitted | Yes |
| 2006-03-01 | Submission has been amended | No |
| 2006-03-01 | This submission is the final filing | No |
| 2006-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-03-01 | Plan is a collectively bargained plan | No |
| 2006-03-01 | Plan funding arrangement – Insurance | Yes |
| 2006-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: MEDAC INC MEDICAL PLAN 2005 form 5500 responses |
|---|
| 2005-03-01 | Type of plan entity | Single employer plan |
| 2005-03-01 | First time form 5500 has been submitted | Yes |
| 2005-03-01 | Submission has been amended | No |
| 2005-03-01 | This submission is the final filing | No |
| 2005-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-03-01 | Plan is a collectively bargained plan | No |
| 2005-03-01 | Plan funding arrangement – Insurance | Yes |
| 2005-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: MEDAC INC MEDICAL PLAN 2004 form 5500 responses |
|---|
| 2004-03-01 | Type of plan entity | Single employer plan |
| 2004-03-01 | First time form 5500 has been submitted | Yes |
| 2004-03-01 | Submission has been amended | No |
| 2004-03-01 | This submission is the final filing | No |
| 2004-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-03-01 | Plan is a collectively bargained plan | No |
| 2004-03-01 | Plan funding arrangement – Insurance | Yes |
| 2004-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2004-01-01 | Type of plan entity | Single employer plan |
| 2004-01-01 | First time form 5500 has been submitted | Yes |
| 2004-01-01 | Submission has been amended | No |
| 2004-01-01 | This submission is the final filing | No |
| 2004-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-01-01 | Plan is a collectively bargained plan | No |
| 2004-01-01 | Plan funding arrangement – Insurance | Yes |
| 2004-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: MEDAC INC MEDICAL PLAN 2003 form 5500 responses |
|---|
| 2003-01-01 | Type of plan entity | Single employer plan |
| 2003-01-01 | First time form 5500 has been submitted | Yes |
| 2003-01-01 | Submission has been amended | No |
| 2003-01-01 | This submission is the final filing | No |
| 2003-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-01-01 | Plan is a collectively bargained plan | No |
| 2003-01-01 | Plan funding arrangement – Insurance | Yes |
| 2003-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 907201 |
| Policy instance | 1 |
| Insurance contract or identification number | 907201 | | Number of Individuals Covered | 633 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $112,787 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $40,366 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker name | ALLIANT INSURANCE SERVICES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000X6353 |
| Policy instance | 2 |
| Insurance contract or identification number | 000X6353 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $29,377 | | Total amount of fees paid to insurance company | USD $6,972 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,377 | | Amount paid for insurance broker fees | 6971 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA7073 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $155,845 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | Yes | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $155,845 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | ARGUS HOLDINGS INC |
|
| ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7073 |
| Policy instance | 1 |
| Insurance contract or identification number | GA7073 | | Number of Individuals Covered | 300 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $128,275 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $127,275 | | Insurance broker name | ARGUS HOLDINGS |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | 104459100 |
| Policy instance | 2 |
| Insurance contract or identification number | 104459100 | | Number of Individuals Covered | 300 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $10,488 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 1020 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $53,231 | | Total amount of fees paid to insurance company | USD $2,310 | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | Yes | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Other information about contract | GROUP PLAN |
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