DOCTOR CENTER HOSPITAL has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan DOCTORS CENTER HOSPITAL MANATI
| Measure | Date | Value |
|---|
| 2024: DOCTORS CENTER HOSPITAL MANATI 2024 401k membership |
|---|
| Total participants, beginning-of-year | 2024-02-01 | 705 |
| Total number of active participants reported on line 7a of the Form 5500 | 2024-02-01 | 699 |
| Total of all active and inactive participants | 2024-02-01 | 699 |
| Total participants | 2024-02-01 | 699 |
| 2023: DOCTORS CENTER HOSPITAL MANATI 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-02-01 | 650 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-02-01 | 705 |
| Total of all active and inactive participants | 2023-02-01 | 705 |
| Total participants | 2023-02-01 | 705 |
| 2022: DOCTORS CENTER HOSPITAL MANATI 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 567 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 650 |
| Total of all active and inactive participants | 2022-02-01 | 650 |
| Total participants | 2022-02-01 | 650 |
| 2021: DOCTORS CENTER HOSPITAL MANATI 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 643 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 567 |
| Total of all active and inactive participants | 2021-02-01 | 567 |
| Total participants | 2021-02-01 | 567 |
| 2020: DOCTORS CENTER HOSPITAL MANATI 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 662 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 643 |
| Total of all active and inactive participants | 2020-02-01 | 643 |
| Total participants | 2020-02-01 | 643 |
| 2019: DOCTORS CENTER HOSPITAL MANATI 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 641 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 662 |
| Total of all active and inactive participants | 2019-02-01 | 662 |
| Total participants | 2019-02-01 | 662 |
| 2018: DOCTORS CENTER HOSPITAL MANATI 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 638 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 641 |
| Total of all active and inactive participants | 2018-02-01 | 641 |
| Total participants | 2018-02-01 | 641 |
| 2017: DOCTORS CENTER HOSPITAL MANATI 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 771 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 638 |
| Total of all active and inactive participants | 2017-02-01 | 638 |
| Total participants | 2017-02-01 | 638 |
| 2016: DOCTORS CENTER HOSPITAL MANATI 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 764 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 771 |
| Total of all active and inactive participants | 2016-02-01 | 771 |
| Total participants | 2016-02-01 | 771 |
| 2015: DOCTORS CENTER HOSPITAL MANATI 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-08-01 | 301 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-08-01 | 764 |
| Total of all active and inactive participants | 2015-08-01 | 764 |
| Total participants | 2015-08-01 | 764 |
| 2014: DOCTORS CENTER HOSPITAL MANATI 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-08-01 | 330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-08-01 | 301 |
| Total of all active and inactive participants | 2014-08-01 | 301 |
| Total participants | 2014-08-01 | 301 |
| 2012: DOCTORS CENTER HOSPITAL MANATI 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 379 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 419 |
| Total of all active and inactive participants | 2012-02-01 | 419 |
| Total participants | 2012-02-01 | 419 |
| 2011: DOCTORS CENTER HOSPITAL MANATI 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 349 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 379 |
| Total of all active and inactive participants | 2011-02-01 | 379 |
| Total participants | 2011-02-01 | 379 |
| 2009: DOCTORS CENTER HOSPITAL MANATI 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-02-01 | 365 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 387 |
| Total of all active and inactive participants | 2009-02-01 | 387 |
| Total participants | 2009-02-01 | 387 |
| 2008: DOCTORS CENTER HOSPITAL MANATI 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-02-01 | 341 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-02-01 | 365 |
| Total of all active and inactive participants | 2008-02-01 | 365 |
| Total participants | 2008-02-01 | 365 |
| 2007: DOCTORS CENTER HOSPITAL MANATI 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-02-01 | 341 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-02-01 | 341 |
| Total of all active and inactive participants | 2007-02-01 | 341 |
| Total participants | 2007-02-01 | 341 |
| 2024: DOCTORS CENTER HOSPITAL MANATI 2024 form 5500 responses |
|---|
| 2024-02-01 | Type of plan entity | Single employer plan |
| 2024-02-01 | Submission has been amended | No |
| 2024-02-01 | This submission is the final filing | No |
| 2024-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2024-02-01 | Plan is a collectively bargained plan | No |
| 2024-02-01 | Plan funding arrangement – Insurance | Yes |
| 2024-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2023: DOCTORS CENTER HOSPITAL MANATI 2023 form 5500 responses |
|---|
| 2023-02-01 | Type of plan entity | Single employer plan |
| 2023-02-01 | Submission has been amended | No |
| 2023-02-01 | This submission is the final filing | No |
| 2023-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-02-01 | Plan is a collectively bargained plan | No |
| 2023-02-01 | Plan funding arrangement – Insurance | Yes |
| 2023-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: DOCTORS CENTER HOSPITAL MANATI 2022 form 5500 responses |
|---|
| 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: DOCTORS CENTER HOSPITAL MANATI 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Submission has been amended | No |
| 2021-02-01 | This submission is the final filing | No |
| 2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-02-01 | Plan is a collectively bargained plan | No |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: DOCTORS CENTER HOSPITAL MANATI 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | No |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: DOCTORS CENTER HOSPITAL MANATI 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Submission has been amended | No |
| 2019-02-01 | This submission is the final filing | No |
| 2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-02-01 | Plan is a collectively bargained plan | No |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: DOCTORS CENTER HOSPITAL MANATI 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Submission has been amended | No |
| 2018-02-01 | This submission is the final filing | No |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-02-01 | Plan is a collectively bargained plan | No |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: DOCTORS CENTER HOSPITAL MANATI 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: DOCTORS CENTER HOSPITAL MANATI 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: DOCTORS CENTER HOSPITAL MANATI 2015 form 5500 responses |
|---|
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | Submission has been amended | No |
| 2015-08-01 | This submission is the final filing | No |
| 2015-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-08-01 | Plan is a collectively bargained plan | No |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: DOCTORS CENTER HOSPITAL MANATI 2014 form 5500 responses |
|---|
| 2014-08-01 | Type of plan entity | Single employer plan |
| 2014-08-01 | Submission has been amended | No |
| 2014-08-01 | This submission is the final filing | No |
| 2014-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-08-01 | Plan is a collectively bargained plan | No |
| 2014-08-01 | Plan funding arrangement – Insurance | Yes |
| 2014-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: DOCTORS CENTER HOSPITAL MANATI 2012 form 5500 responses |
|---|
| 2012-02-01 | Type of plan entity | Single employer plan |
| 2012-02-01 | Submission has been amended | No |
| 2012-02-01 | This submission is the final filing | No |
| 2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-02-01 | Plan is a collectively bargained plan | No |
| 2012-02-01 | Plan funding arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: DOCTORS CENTER HOSPITAL MANATI 2011 form 5500 responses |
|---|
| 2011-02-01 | Type of plan entity | Single employer plan |
| 2011-02-01 | Submission has been amended | No |
| 2011-02-01 | This submission is the final filing | No |
| 2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-02-01 | Plan is a collectively bargained plan | No |
| 2011-02-01 | Plan funding arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: DOCTORS CENTER HOSPITAL MANATI 2009 form 5500 responses |
|---|
| 2009-02-01 | Type of plan entity | Single employer plan |
| 2009-02-01 | Submission has been amended | No |
| 2009-02-01 | This submission is the final filing | No |
| 2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-02-01 | Plan is a collectively bargained plan | No |
| 2009-02-01 | Plan funding arrangement – Insurance | Yes |
| 2009-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: DOCTORS CENTER HOSPITAL MANATI 2008 form 5500 responses |
|---|
| 2008-02-01 | Type of plan entity | Single employer plan |
| 2008-02-01 | Submission has been amended | No |
| 2008-02-01 | This submission is the final filing | No |
| 2008-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-02-01 | Plan is a collectively bargained plan | No |
| 2008-02-01 | Plan funding arrangement – Insurance | Yes |
| 2008-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: DOCTORS CENTER HOSPITAL MANATI 2007 form 5500 responses |
|---|
| 2007-02-01 | Type of plan entity | Single employer plan |
| 2007-02-01 | First time form 5500 has been submitted | Yes |
| 2007-02-01 | Submission has been amended | Yes |
| 2007-02-01 | This submission is the final filing | No |
| 2007-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-02-01 | Plan is a collectively bargained plan | No |
| 2007-02-01 | Plan funding arrangement – Insurance | Yes |
| 2007-02-01 | Plan benefit arrangement – Insurance | Yes |
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0007414 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0007414 | | Number of Individuals Covered | 699 | | Insurance policy start date | 2024-02-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $7,153 | | 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 | Yes | | 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 | MAJOR MEDICAL, TELECONSULTA, QUICK HELP, ORGAN & TISSUE TRANSPLANT | | 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 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0007414 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0007414 | | Number of Individuals Covered | 705 | | Insurance policy start date | 2023-02-01 | | Insurance policy end date | 2024-01-31 | | Total amount of commissions paid to insurance broker | USD $91,571 | | 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 | Yes | | 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 | MAAJOR MEDICAL, QUICKHELP, ORGAN & TISSUE TRANSPLANT, TELECONSULTA | | 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 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0007414 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0007414 | | Number of Individuals Covered | 650 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $72,365 | | 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 | Yes | | 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 | MAJOR MEDICAL, QUICK HELP, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 $72,365 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 ) |
| Policy contract number | 79-791617 |
| Policy instance | 1 |
| Insurance contract or identification number | 79-791617 | | Number of Individuals Covered | 567 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $80,761 | | Total amount of fees paid to insurance company | USD $16,152 | | 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 | Yes | | 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 | | 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 $80,761 | | Amount paid for insurance broker fees | 16152 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 643 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $73,405 | | 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 | 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 | | Other welfare benefits provided | MAJOR MEDICAL, QUICK HELP, TELECONSULTA, ORGAN & TISSUE TRANSPLANT | | 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 $73,405 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 662 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $88,936 | | 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 | 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 | | Other welfare benefits provided | MAJOR MEDICAL, QUICK HELP, TELECONSULTA, ORGAN AND TISSUE TRANSPLANT | | 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 $88,936 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 641 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $86,032 | | 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 | 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 | | Other welfare benefits provided | MAJOR MEDICAL, QUICKHELP, ORGAN & TISSUE TRANSPLANT | | 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 $8,603 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 638 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $86,489 | | 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 | 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 | | Other welfare benefits provided | MAJOR MEDICAL, QUICK HELP, TELECONSULTA, ORGAN AND TISSUE TRANSPLANT | | 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 $86,489 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | FEDELTA INSURANCE CORP |
|
| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 764 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-01-31 | | Total amount of commissions paid to insurance broker | USD $23,225 | | 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 | Yes | | 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 | | Other welfare benefits provided | MAJOR MEDICAL, ORGAN AND TISSUE TRANSPLANT, QUICKHELP, TELECONSULTA | | 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 $23,225 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | FEDELTA INSURANCE CORP |
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| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 301 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $31,638 | | 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 | Yes | | 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 | | Other welfare benefits provided | MAJOR MEDICAL, ORGAN AND TISSUE TRANSPLANT, QUICK HELP, TELECONSULTA | | 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? | Yes | | Commission paid to Insurance Broker | USD $31,638 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | FEDELTA INSURANCE CORP |
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| MAPFRE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77054 ) |
| Policy contract number | 357843 |
| Policy instance | 1 |
| Insurance contract or identification number | 357843 | | Number of Individuals Covered | 453 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $38,960 | | 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 | Yes | | 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 |
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| TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 ) |
| Policy contract number | SP0003978 |
| Policy instance | 1 |
| Insurance contract or identification number | SP0003978 | | Number of Individuals Covered | 330 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-07-31 | | Total amount of commissions paid to insurance broker | USD $19,302 | | 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 | Yes | | 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 |
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| PAN AMERICAN LIFE INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 12952 ) |
| Policy contract number | 88546 |
| Policy instance | 1 |
| Insurance contract or identification number | 88546 | | Number of Individuals Covered | 419 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $35,195 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 35195 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | FEDELTA INSURANCE GROUP |
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| PAN AMERICAN LIFE INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 12952 ) |
| Policy contract number | 88546 |
| Policy instance | 1 |
| Insurance contract or identification number | 88546 | | Number of Individuals Covered | 379 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $31,282 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| PAN AMERICAN LIFE INSURANCE GROUP (National Association of Insurance Commissioners NAIC id number: 12952 ) |
| Policy contract number | 88546 |
| Policy instance | 1 |
| Insurance contract or identification number | 88546 | | Number of Individuals Covered | 349 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $28,209 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 ) |
| Policy contract number | 117186 |
| Policy instance | 1 |
| Insurance contract or identification number | 117186 | | Number of Individuals Covered | 365 | | Insurance policy start date | 2008-02-01 | | Insurance policy end date | 2009-01-31 | | Total amount of commissions paid to insurance broker | USD $29,810 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,810 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | THE LOYALTY INSURANCE SERV., INC |
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| HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 ) |
| Policy contract number | 117186 |
| Policy instance | 1 |
| Insurance contract or identification number | 117186 | | Number of Individuals Covered | 341 | | Insurance policy start date | 2007-02-01 | | Insurance policy end date | 2008-01-31 | | Total amount of commissions paid to insurance broker | USD $26,689 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,689 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | THE LOYALTY INSURANCE SERV., INC |
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