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VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 401k Plan overview

Plan NameVUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN
Plan identification number 501

VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN Benefits

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

401k Sponsoring company profile

VUTEQ USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:VUTEQ USA, INC.
Employer identification number (EIN):611119251
NAIC Classification:327210

Additional information about VUTEQ USA, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2005-02-17
Company Identification Number: 0800455218
Legal Registered Office Address: 100 CARLEY DR

GEORGETOWN
United States of America (USA)
40324

More information about VUTEQ USA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-02-01RICK ROGERS2024-08-14
5012022-02-01RICK ROGERS2023-08-03
5012021-02-01RICK ROGERS2022-07-11
5012020-02-01RICK ROGERS2021-10-19
5012019-02-01RICK ROGERS2020-08-12
5012019-02-01RICK ROGERS2021-10-19
5012018-02-01RICK ROGERS2019-08-13
5012018-02-01RICK ROGERS2021-10-19
5012017-02-01
5012017-02-01RICK ROGERS2021-10-19
5012016-02-01
5012016-02-01RICK ROGERS2021-10-19
5012015-02-01RICK ROGERS
5012015-02-01RICK ROGERS2021-10-13
5012014-02-01RICK ROGERS
5012013-02-01RICK ROGERS
5012012-02-01RICK ROGERS
5012011-02-01RICK ROGERS
5012009-02-01RICK ROGERS RICK ROGERS2010-11-08

Plan Statistics for VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN

401k plan membership statisitcs for VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN

Measure Date Value
2023: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-02-01314
Total number of active participants reported on line 7a of the Form 55002023-02-011,057
Number of retired or separated participants receiving benefits2023-02-011
Number of other retired or separated participants entitled to future benefits2023-02-010
Total of all active and inactive participants2023-02-011,058
Number of employers contributing to the scheme2023-02-010
2022: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-02-01675
Total number of active participants reported on line 7a of the Form 55002022-02-01314
Number of retired or separated participants receiving benefits2022-02-010
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01314
Number of employers contributing to the scheme2022-02-010
2021: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-02-01611
Total number of active participants reported on line 7a of the Form 55002021-02-01675
Number of retired or separated participants receiving benefits2021-02-010
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01675
Number of employers contributing to the scheme2021-02-010
2020: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-01518
Total number of active participants reported on line 7a of the Form 55002020-02-01611
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01611
Number of employers contributing to the scheme2020-02-010
2019: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01562
Total number of active participants reported on line 7a of the Form 55002019-02-01518
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01518
Number of employers contributing to the scheme2019-02-010
2018: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01210
Total number of active participants reported on line 7a of the Form 55002018-02-01562
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01562
Number of employers contributing to the scheme2018-02-010
2017: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01201
Total number of active participants reported on line 7a of the Form 55002017-02-01210
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01210
Number of employers contributing to the scheme2017-02-010
2016: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01776
Total number of active participants reported on line 7a of the Form 55002016-02-01201
Number of retired or separated participants receiving benefits2016-02-010
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01201
Number of employers contributing to the scheme2016-02-010
2015: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-01776
Total number of active participants reported on line 7a of the Form 55002015-02-01776
Total of all active and inactive participants2015-02-01776
Number of retired or separated participants receiving benefits2015-02-010
Number of other retired or separated participants entitled to future benefits2015-02-010
Number of employers contributing to the scheme2015-02-010
2014: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-01704
Total number of active participants reported on line 7a of the Form 55002014-02-01776
Total of all active and inactive participants2014-02-01776
2013: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-02-01611
Total number of active participants reported on line 7a of the Form 55002013-02-01704
Total of all active and inactive participants2013-02-01704
2012: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-02-01580
Total number of active participants reported on line 7a of the Form 55002012-02-01611
Number of retired or separated participants receiving benefits2012-02-010
Number of other retired or separated participants entitled to future benefits2012-02-010
Total of all active and inactive participants2012-02-01611
2011: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-02-01544
Total number of active participants reported on line 7a of the Form 55002011-02-01586
Number of retired or separated participants receiving benefits2011-02-013
Total of all active and inactive participants2011-02-01589
2009: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-02-01532
Total number of active participants reported on line 7a of the Form 55002009-02-01495
Number of retired or separated participants receiving benefits2009-02-018
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-01503

Form 5500 Responses for VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN

2023: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2023 form 5500 responses
2023-02-01Type of plan entitySingle employer plan
2023-02-01Plan funding arrangement – InsuranceYes
2023-02-01Plan funding arrangement – General assets of the sponsorYes
2023-02-01Plan benefit arrangement – InsuranceYes
2023-02-01Plan benefit arrangement – General assets of the sponsorYes
2022: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – General assets of the sponsorYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement – General assets of the sponsorYes
2021: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – General assets of the sponsorYes
2021-02-01Plan benefit arrangement – InsuranceYes
2021-02-01Plan benefit arrangement – General assets of the sponsorYes
2020: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – General assets of the sponsorYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – General assets of the sponsorYes
2019: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedYes
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – General assets of the sponsorYes
2018: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedYes
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – General assets of the sponsorYes
2017: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedYes
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – General assets of the sponsorYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – General assets of the sponsorYes
2016: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – General assets of the sponsorYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – General assets of the sponsorYes
2015: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – General assets of the sponsorYes
2014: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – General assets of the sponsorYes
2014-02-01Plan benefit arrangement – General assets of the sponsorYes
2013: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – General assets of the sponsorYes
2013-02-01Plan benefit arrangement – General assets of the sponsorYes
2012: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – General assets of the sponsorYes
2012-02-01Plan benefit arrangement – General assets of the sponsorYes
2011: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – General assets of the sponsorYes
2011-02-01Plan benefit arrangement – General assets of the sponsorYes
2009: VUTEQ USA INC. EMPLOYEE HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – General assets of the sponsorYes
2009-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10432951001
Policy instance 1
Insurance contract or identification number10432951001
Number of Individuals Covered2485
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $14,034
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $101,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number400259953
Policy instance 1
Insurance contract or identification number400259953
Number of Individuals Covered737
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,450
Total amount of fees paid to insurance companyUSD $2,481
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,450
Amount paid for insurance broker fees2481
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
IU HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberIU2013
Policy instance 2
Insurance contract or identification numberIU2013
Number of Individuals Covered1409
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $121,598
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,638,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $121,598
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number400259953
Policy instance 1
Insurance contract or identification number400259953
Number of Individuals Covered644
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,687
Total amount of fees paid to insurance companyUSD $2,046
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,687
Amount paid for insurance broker fees2046
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
IU HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberIU2013
Policy instance 2
Insurance contract or identification numberIU2013
Number of Individuals Covered1314
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $97,402
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,926,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $97,402
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number400259953
Policy instance 1
Insurance contract or identification number400259953
Number of Individuals Covered630
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,226
Total amount of fees paid to insurance companyUSD $1,961
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,226
Amount paid for insurance broker fees1961
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
IU HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberIU2013
Policy instance 2
Insurance contract or identification numberIU2013
Number of Individuals Covered1131
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,189,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number920315
Policy instance 1
Insurance contract or identification number920315
Number of Individuals Covered791
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,952
Total amount of fees paid to insurance companyUSD $9,587
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,952
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
IU HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number11CRC8530501
Policy instance 2
Insurance contract or identification number11CRC8530501
Number of Individuals Covered1206
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,545,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5466917
Policy instance 1
Insurance contract or identification number5466917
Number of Individuals Covered481
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,903
Total amount of fees paid to insurance companyUSD $6,025
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,903
Amount paid for insurance broker fees6025
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5469917
Policy instance 1
Insurance contract or identification number5469917
Number of Individuals Covered481
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,903
Total amount of fees paid to insurance companyUSD $6,025
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,903
Amount paid for insurance broker fees6025
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
IU HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberIU2013
Policy instance 2
Insurance contract or identification numberIU2013
Number of Individuals Covered1206
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
Welfare Benefit Premiums Paid to CarrierUSD $6,545,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5466917
Policy instance 1
Insurance contract or identification number5466917
Number of Individuals Covered494
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,521
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,521
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5469917
Policy instance 1
Insurance contract or identification number5469917
Number of Individuals Covered494
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,521
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,521
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5469917
Policy instance 1
Insurance contract or identification number5469917
Number of Individuals Covered472
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $8,728
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,728
Amount paid for insurance broker fees0
Insurance broker organization code?3
ARCH INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number417004410142
Policy instance 2
Insurance contract or identification number417004410142
Number of Individuals Covered776
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $76,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5469917
Policy instance 1
Insurance contract or identification number5469917
Number of Individuals Covered476
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $8,385
Total amount of fees paid to insurance companyUSD $5,362
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,385
Amount paid for insurance broker fees5362
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417005410142
Policy instance 3
Insurance contract or identification number417005410142
Number of Individuals Covered776
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $71,445
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $387,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,445
Insurance broker organization code?3
Insurance broker nameUSI MIDWEST INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5469917
Policy instance 2
Insurance contract or identification number5469917
Number of Individuals Covered476
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $8,385
Total amount of fees paid to insurance companyUSD $5,362
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $83,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,385
Amount paid for insurance broker fees5362
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameUSI MIDWEST INC
ARCH INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number417004410142
Policy instance 1
Insurance contract or identification number417004410142
Number of Individuals Covered776
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRANSPLANT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $76,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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