HOSPITAL SAN CARLOS BORROMEO has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN
401k plan membership statisitcs for HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN
Measure | Date | Value |
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2022: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-02-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 255 |
Total of all active and inactive participants | 2022-02-01 | 255 |
Total participants | 2022-02-01 | 255 |
2021: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-05-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 318 |
Total of all active and inactive participants | 2021-05-01 | 318 |
Total participants | 2021-05-01 | 318 |
2020: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 301 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 318 |
Total of all active and inactive participants | 2020-05-01 | 318 |
Total participants | 2020-05-01 | 318 |
2019: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-05-01 | 263 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 301 |
Total of all active and inactive participants | 2019-05-01 | 301 |
Total participants | 2019-05-01 | 301 |
2018: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-05-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 263 |
Total of all active and inactive participants | 2018-05-01 | 263 |
Total participants | 2018-05-01 | 263 |
2017: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 262 |
Total of all active and inactive participants | 2017-05-01 | 262 |
Total participants | 2017-05-01 | 262 |
2016: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 298 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 262 |
Total of all active and inactive participants | 2016-05-01 | 262 |
Total participants | 2016-05-01 | 262 |
2015: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 326 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 298 |
Total of all active and inactive participants | 2015-05-01 | 298 |
Total participants | 2015-05-01 | 298 |
2014: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 325 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 326 |
Total of all active and inactive participants | 2014-05-01 | 326 |
Total participants | 2014-05-01 | 326 |
2013: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 325 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 325 |
Total of all active and inactive participants | 2013-05-01 | 325 |
Total participants | 2013-05-01 | 325 |
2012: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 320 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 325 |
Total of all active and inactive participants | 2012-05-01 | 325 |
Total participants | 2012-05-01 | 325 |
2011: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 300 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 320 |
Total of all active and inactive participants | 2011-05-01 | 320 |
Total participants | 2011-05-01 | 320 |
2010: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-05-01 | 301 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 300 |
Total of all active and inactive participants | 2010-05-01 | 300 |
Total participants | 2010-05-01 | 300 |
2022: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2022 form 5500 responses |
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2022-02-01 | Type of plan entity | Single employer plan |
2022-02-01 | Submission has been amended | No |
2022-02-01 | This submission is the final filing | No |
2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-02-01 | Plan is a collectively bargained plan | No |
2022-02-01 | Plan funding arrangement – Insurance | Yes |
2022-02-01 | Plan benefit arrangement – Insurance | Yes |
2021: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2021 form 5500 responses |
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2021-05-01 | Type of plan entity | Single employer plan |
2021-05-01 | Submission has been amended | No |
2021-05-01 | This submission is the final filing | No |
2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2021-05-01 | Plan is a collectively bargained plan | No |
2021-05-01 | Plan funding arrangement – Insurance | Yes |
2021-05-01 | Plan benefit arrangement – Insurance | Yes |
2020: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Submission has been amended | No |
2020-05-01 | This submission is the final filing | No |
2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-05-01 | Plan is a collectively bargained plan | No |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2019: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2019 form 5500 responses |
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2019-05-01 | Type of plan entity | Single employer plan |
2019-05-01 | Submission has been amended | No |
2019-05-01 | This submission is the final filing | No |
2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-05-01 | Plan is a collectively bargained plan | No |
2019-05-01 | Plan funding arrangement – Insurance | Yes |
2019-05-01 | Plan benefit arrangement – Insurance | Yes |
2018: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2018 form 5500 responses |
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2018-05-01 | Type of plan entity | Single employer plan |
2018-05-01 | Submission has been amended | No |
2018-05-01 | This submission is the final filing | No |
2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-05-01 | Plan is a collectively bargained plan | No |
2018-05-01 | Plan funding arrangement – Insurance | Yes |
2018-05-01 | Plan benefit arrangement – Insurance | Yes |
2017: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Submission has been amended | No |
2017-05-01 | This submission is the final filing | No |
2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-05-01 | Plan is a collectively bargained plan | No |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2016: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Submission has been amended | No |
2016-05-01 | This submission is the final filing | No |
2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-05-01 | Plan is a collectively bargained plan | No |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2015: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Submission has been amended | No |
2015-05-01 | This submission is the final filing | No |
2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-05-01 | Plan is a collectively bargained plan | No |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2014: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Submission has been amended | No |
2014-05-01 | This submission is the final filing | No |
2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-05-01 | Plan is a collectively bargained plan | No |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2013: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2013 form 5500 responses |
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2013-05-01 | Type of plan entity | Single employer plan |
2013-05-01 | Submission has been amended | No |
2013-05-01 | This submission is the final filing | No |
2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-05-01 | Plan is a collectively bargained plan | No |
2013-05-01 | Plan funding arrangement – Insurance | Yes |
2013-05-01 | Plan benefit arrangement – Insurance | Yes |
2012: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2012 form 5500 responses |
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2012-05-01 | Type of plan entity | Single employer plan |
2012-05-01 | Submission has been amended | No |
2012-05-01 | This submission is the final filing | No |
2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-05-01 | Plan is a collectively bargained plan | No |
2012-05-01 | Plan funding arrangement – Insurance | Yes |
2012-05-01 | Plan benefit arrangement – Insurance | Yes |
2011: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2011 form 5500 responses |
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2011-05-01 | Type of plan entity | Single employer plan |
2011-05-01 | Submission has been amended | No |
2011-05-01 | This submission is the final filing | No |
2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-05-01 | Plan is a collectively bargained plan | No |
2011-05-01 | Plan funding arrangement – Insurance | Yes |
2011-05-01 | Plan benefit arrangement – Insurance | Yes |
2010: HOSPITAL SAN CARLOS BORROMEO BASIC LIFE & AD&D PLAN 2010 form 5500 responses |
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2010-05-01 | Type of plan entity | Single employer plan |
2010-05-01 | Submission has been amended | No |
2010-05-01 | This submission is the final filing | No |
2010-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-05-01 | Plan is a collectively bargained plan | No |
2010-05-01 | Plan funding arrangement – Insurance | Yes |
2010-05-01 | Plan benefit arrangement – Insurance | Yes |
MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 ) |
Policy contract number | 1-5033-000 |
Policy instance | 1 |
Insurance contract or identification number | 1-5033-000 | Number of Individuals Covered | 255 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $857 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $857 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 |
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MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 ) |
Policy contract number | 1-5033-000 |
Policy instance | 1 |
Insurance contract or identification number | 1-5033-000 | Number of Individuals Covered | 318 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $643 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $643 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 |
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MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 ) |
Policy contract number | 1-5033-000 |
Policy instance | 1 |
Insurance contract or identification number | 1-5033-000 | Number of Individuals Covered | 318 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $873 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $873 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 |
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MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 ) |
Policy contract number | 1-5033-000 |
Policy instance | 1 |
Insurance contract or identification number | 1-5033-000 | Number of Individuals Covered | 301 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $894 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $894 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 |
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MULTINATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 72087 ) |
Policy contract number | 72087 |
Policy instance | 1 |
Insurance contract or identification number | 72087 | Number of Individuals Covered | 263 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $889 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $889 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069G |
Policy instance | 1 |
Insurance contract or identification number | 869069G | Number of Individuals Covered | 262 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $1,307 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $1,307 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 | Insurance broker name | IKON BENEFITS GROUP, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069G |
Policy instance | 1 |
Insurance contract or identification number | 869069G | Number of Individuals Covered | 298 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $1,486 | Total amount of fees paid to insurance company | USD $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 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $1,486 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 | Insurance broker name | IKON BENEFITS GROUP, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069G |
Policy instance | 1 |
Insurance contract or identification number | 869069G | Number of Individuals Covered | 326 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $1,502 | Total amount of fees paid to insurance company | USD $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 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $1,502 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 | Insurance broker name | IKON BENEFITS GROUP, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069G |
Policy instance | 1 |
Insurance contract or identification number | 869069G | Number of Individuals Covered | 325 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $1,482 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $1,482 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 | Insurance broker name | IKON BENEFITS GROUP, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069-0GL |
Policy instance | 1 |
Insurance contract or identification number | 869069-0GL | Number of Individuals Covered | 325 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $1,326 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,326 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BROKER | Insurance broker organization code? | 3 | Insurance broker name | IKON INSURANCE, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 8690369G |
Policy instance | 1 |
Insurance contract or identification number | 8690369G | Number of Individuals Covered | 320 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $1,193 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 869069G |
Policy instance | 1 |
Insurance contract or identification number | 869069G | Number of Individuals Covered | 300 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $1,266 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
Policy contract number | GL/ADD0605-0066 |
Policy instance | 2 |
Insurance contract or identification number | GL/ADD0605-0066 | Number of Individuals Covered | 301 | Insurance policy start date | 2009-05-01 | Insurance policy end date | 2010-04-30 | Total amount of commissions paid to insurance broker | USD $1,368 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
Policy contract number | GL/ADD0605-0066 |
Policy instance | 3 |
Insurance contract or identification number | GL/ADD0605-0066 | Number of Individuals Covered | 326 | Insurance policy start date | 2008-05-01 | Insurance policy end date | 2009-04-30 | Total amount of commissions paid to insurance broker | USD $1,634 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
Policy contract number | GL/ADD0605-0066 |
Policy instance | 4 |
Insurance contract or identification number | GL/ADD0605-0066 | Number of Individuals Covered | 354 | Insurance policy start date | 2007-05-01 | Insurance policy end date | 2008-04-30 | Total amount of commissions paid to insurance broker | USD $1,684 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIVERSAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60041 ) |
Policy contract number | GL/ADD0605-0066 |
Policy instance | 5 |
Insurance contract or identification number | GL/ADD0605-0066 | Number of Individuals Covered | 363 | Insurance policy start date | 2006-05-01 | Insurance policy end date | 2007-04-30 | Total amount of commissions paid to insurance broker | USD $1,693 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SECUROS DE VIDA TRIPLE-S INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | V-0505002 |
Policy instance | 6 |
Insurance contract or identification number | V-0505002 | Number of Individuals Covered | 334 | Insurance policy start date | 2005-05-01 | Insurance policy end date | 2006-04-30 | Total amount of commissions paid to insurance broker | USD $1,296 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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