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ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN
Plan identification number 506

ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

ARKANSAS CHILDREN'S, INC has sponsored the creation of one or more 401k plans.

Company Name:ARKANSAS CHILDREN'S, INC
Employer identification number (EIN):710236857
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062022-01-01CRYSTAL KOHANKE2023-10-12
5062021-01-01CRYSTAL KOHANKE2022-10-12
5062020-01-01CRYSTAL KOHANKE2021-10-15
5062019-01-01BRENT THOMPSON2020-10-15
5062018-07-01JIMMY DUNCAN2019-10-10
5062017-07-01JIMMY DUNCAN2019-04-12
5062016-07-01
5062015-07-01
5062014-07-01RAMON C. HENDERSON
5062013-07-01LARRY D. NAYSMITH CHERYL L. EDWARDS2014-10-28
5062012-07-01LARRY D. NAYSMITH LARRY D. NAYSMITH2013-11-26
5062011-07-01LARRY D. NAYSMITH LARRY D. NAYSMITH2012-12-09
5062009-07-01LARRY D. NAYSMITH LARRY D. NAYSMITH2011-01-14

Plan Statistics for ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2022: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-013,241
Total number of active participants reported on line 7a of the Form 55002022-01-013,595
Total of all active and inactive participants2022-01-013,595
Total participants2022-01-010
2021: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-013,238
Total number of active participants reported on line 7a of the Form 55002021-01-013,241
Total of all active and inactive participants2021-01-013,241
Total participants2021-01-013,241
2020: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-013,291
Total number of active participants reported on line 7a of the Form 55002020-01-013,207
Number of retired or separated participants receiving benefits2020-01-0131
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,238
Total participants2020-01-013,238
2019: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-013,350
Total number of active participants reported on line 7a of the Form 55002019-01-013,254
Number of retired or separated participants receiving benefits2019-01-0120
Number of other retired or separated participants entitled to future benefits2019-01-0117
Total of all active and inactive participants2019-01-013,291
Total participants2019-01-013,291
2018: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-013,136
Total number of active participants reported on line 7a of the Form 55002018-07-013,123
Number of retired or separated participants receiving benefits2018-07-0141
Number of other retired or separated participants entitled to future benefits2018-07-0160
Total of all active and inactive participants2018-07-013,224
Total participants2018-07-013,224
2017: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-013,133
Total number of active participants reported on line 7a of the Form 55002017-07-013,133
Number of retired or separated participants receiving benefits2017-07-0125
Total of all active and inactive participants2017-07-013,158
Total participants2017-07-013,158
2016: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-013,221
Total number of active participants reported on line 7a of the Form 55002016-07-013,409
Number of retired or separated participants receiving benefits2016-07-0125
Number of other retired or separated participants entitled to future benefits2016-07-011
Total of all active and inactive participants2016-07-013,435
Total participants2016-07-013,435
2015: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-013,323
Total number of active participants reported on line 7a of the Form 55002015-07-013,196
Number of retired or separated participants receiving benefits2015-07-0192
Number of other retired or separated participants entitled to future benefits2015-07-015
Total of all active and inactive participants2015-07-013,293
Total participants2015-07-013,293
2014: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-013,423
Total number of active participants reported on line 7a of the Form 55002014-07-013,262
Number of retired or separated participants receiving benefits2014-07-0124
Number of other retired or separated participants entitled to future benefits2014-07-014
Total of all active and inactive participants2014-07-013,290
Total participants2014-07-013,290
2013: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-013,023
Total number of active participants reported on line 7a of the Form 55002013-07-013,387
Number of retired or separated participants receiving benefits2013-07-0136
Number of other retired or separated participants entitled to future benefits2013-07-0136
Total of all active and inactive participants2013-07-013,459
2012: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-012,982
Total number of active participants reported on line 7a of the Form 55002012-07-013,023
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-013,023
2011: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-013,000
Total number of active participants reported on line 7a of the Form 55002011-07-012,982
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-012,982
2009: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-013,275
Total number of active participants reported on line 7a of the Form 55002009-07-013,323
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-013,323

Financial Data on ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2021 : ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2021 401k financial data
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2021-12-310
Minimum employer required contribution for this plan year2021-12-31$0
Amount contributed by the employer to the plan for this plan year2021-12-31$0

Form 5500 Responses for ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN

2022: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: ARKANSAS CHILDRENS HOSPITAL FLEXIBLE BENEFITS PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan 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 number10077541001
Policy instance 4
Insurance contract or identification number10077541001
Number of Individuals Covered22
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $189
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $144
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 3
Insurance contract or identification number97492351001
Number of Individuals Covered5583
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $44,883
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $417,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,111
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 2
Insurance contract or identification numberOA434
Number of Individuals Covered44
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,214
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $45,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,758
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000000520
Policy instance 1
Insurance contract or identification number000000520
Number of Individuals Covered7053
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $45,914
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,914
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000000520
Policy instance 1
Insurance contract or identification number000000520
Number of Individuals Covered6849
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $45,729
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,729
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 2
Insurance contract or identification numberOA434
Number of Individuals Covered49
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,085
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $44,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,731
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 3
Insurance contract or identification number97492351001
Number of Individuals Covered5441
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $44,485
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $456,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,809
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10077541001
Policy instance 4
Insurance contract or identification number10077541001
Number of Individuals Covered26
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $95
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10077541001
Policy instance 4
Insurance contract or identification number10077541001
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $187
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $142
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 3
Insurance contract or identification number97492351001
Number of Individuals Covered5344
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $39,748
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $405,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,208
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 2
Insurance contract or identification numberOA434
Number of Individuals Covered54
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,348
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $54,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,479
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000000520
Policy instance 1
Insurance contract or identification number000000520
Number of Individuals Covered6857
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $42,918
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,918
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000000520
Policy instance 1
Insurance contract or identification number000000520
Number of Individuals Covered6936
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $37,599
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,599
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 2
Insurance contract or identification numberOA434
Number of Individuals Covered60
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $10,133
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $63,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,690
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 3
Insurance contract or identification number97492351001
Number of Individuals Covered5336
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $34,723
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $357,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,390
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10077541001
Policy instance 4
Insurance contract or identification number10077541001
Number of Individuals Covered26
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $201
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 2
Insurance contract or identification numberOA434
Number of Individuals Covered216
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,571
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $35,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,500
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10077541001
Policy instance 4
Insurance contract or identification number10077541001
Number of Individuals Covered27
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $120
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 3
Insurance contract or identification number97492351001
Number of Individuals Covered5160
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,839
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,798
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number000000520
Policy instance 1
Insurance contract or identification number000000520
Number of Individuals Covered6949
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $27,088
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,088
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97492351001
Policy instance 4
Insurance contract or identification number97492351001
Number of Individuals Covered4934
Insurance policy start date2017-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $33,680
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $339,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 )
Policy contract number0520
Policy instance 1
Insurance contract or identification number0520
Number of Individuals Covered6823
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $39,774
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberOA434
Policy instance 3
Insurance contract or identification numberOA434
Number of Individuals Covered234
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $10,199
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $64,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number6251
Policy instance 2
Insurance contract or identification number6251
Number of Individuals Covered3736
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $172,193
Other welfare benefits providedACCIDENT & CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $1,238,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10077541001
Policy instance 5
Insurance contract or identification number10077541001
Number of Individuals Covered45
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $299
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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