WASHINGTON REGIONAL MEDICAL CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN
401k plan membership statisitcs for WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $168,828 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $886,005 |
| Total income from all sources (including contributions) | 2022-12-31 | $21,788,422 |
| Total of all expenses incurred | 2022-12-31 | $19,456,702 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $18,157,148 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $21,764,751 |
| Value of total assets at end of year | 2022-12-31 | $2,596,891 |
| Value of total assets at beginning of year | 2022-12-31 | $982,348 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $1,299,554 |
| Total interest from all sources | 2022-12-31 | $23,671 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $3,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $5,778,188 |
| Participant contributions at end of year | 2022-12-31 | $247,166 |
| Participant contributions at beginning of year | 2022-12-31 | $20,998 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $1,315,470 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $582,809 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $168,828 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $886,005 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $2,331,720 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $2,428,063 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $96,343 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $23,671 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $206,174 |
| Asset value of US Government securities at end of year | 2022-12-31 | $412,423 |
| Asset value of US Government securities at beginning of year | 2022-12-31 | $327,502 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $15,986,563 |
| Employer contributions (assets) at end of year | 2022-12-31 | $621,832 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $51,039 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $17,950,974 |
| Contract administrator fees | 2022-12-31 | $1,299,554 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | FORVIS, LLP |
| Accountancy firm EIN | 2022-12-31 | 440160260 |
| 2021 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $886,005 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $89,562 |
| Total income from all sources (including contributions) | 2021-12-31 | $18,406,447 |
| Total of all expenses incurred | 2021-12-31 | $21,677,458 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $20,520,533 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $18,406,447 |
| Value of total assets at end of year | 2021-12-31 | $982,348 |
| Value of total assets at beginning of year | 2021-12-31 | $3,456,916 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $1,156,925 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $3,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $4,995,684 |
| Participant contributions at end of year | 2021-12-31 | $20,998 |
| Participant contributions at beginning of year | 2021-12-31 | $23,319 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $582,809 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $1,064,166 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $886,005 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $89,562 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-3,271,011 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $96,343 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $3,367,354 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $805,309 |
| Asset value of US Government securities at end of year | 2021-12-31 | $327,502 |
| Asset value of US Government securities at beginning of year | 2021-12-31 | $2,311,743 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $13,410,763 |
| Employer contributions (assets) at end of year | 2021-12-31 | $51,039 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $57,688 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $19,715,224 |
| Contract administrator fees | 2021-12-31 | $1,156,925 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | FORVIS, LLP |
| Accountancy firm EIN | 2021-12-31 | 440160260 |
| 2020 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $89,562 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $316,120 |
| Total income from all sources (including contributions) | 2020-12-31 | $18,220,582 |
| Total of all expenses incurred | 2020-12-31 | $15,758,513 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $14,758,523 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $18,217,781 |
| Value of total assets at end of year | 2020-12-31 | $3,456,916 |
| Value of total assets at beginning of year | 2020-12-31 | $1,221,405 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $999,990 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $2,801 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $2,801 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $3,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $5,171,884 |
| Participant contributions at end of year | 2020-12-31 | $23,319 |
| Participant contributions at beginning of year | 2020-12-31 | $52,680 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $1,064,166 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $316,332 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $89,562 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $316,120 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $2,462,069 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $3,367,354 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $905,285 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $853,786 |
| Asset value of US Government securities at end of year | 2020-12-31 | $2,311,743 |
| Asset value of US Government securities at beginning of year | 2020-12-31 | $831,069 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $13,045,897 |
| Employer contributions (assets) at end of year | 2020-12-31 | $57,688 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $21,324 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $13,904,737 |
| Contract administrator fees | 2020-12-31 | $999,990 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | BKD, LLP |
| Accountancy firm EIN | 2020-12-31 | 440160260 |
| 2019 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $316,120 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $177,045 |
| Total income from all sources (including contributions) | 2019-12-31 | $17,878,784 |
| Total of all expenses incurred | 2019-12-31 | $17,771,618 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $16,679,970 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $17,863,003 |
| Value of total assets at end of year | 2019-12-31 | $1,221,405 |
| Value of total assets at beginning of year | 2019-12-31 | $975,164 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $1,091,648 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $15,781 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $15,781 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $3,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $4,865,301 |
| Participant contributions at end of year | 2019-12-31 | $52,680 |
| Participant contributions at beginning of year | 2019-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $316,332 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $664,372 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $316,120 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $177,045 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $107,166 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $905,285 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $798,119 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $788,206 |
| Asset value of US Government securities at end of year | 2019-12-31 | $831,069 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $310,792 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $12,997,702 |
| Employer contributions (assets) at end of year | 2019-12-31 | $21,324 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $15,891,764 |
| Contract administrator fees | 2019-12-31 | $1,091,648 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | BKD, LLP |
| Accountancy firm EIN | 2019-12-31 | 440160260 |
| 2018 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $177,045 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $79,996 |
| Total income from all sources (including contributions) | 2018-12-31 | $14,749,201 |
| Total of all expenses incurred | 2018-12-31 | $16,336,163 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $15,373,424 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $14,726,524 |
| Value of total assets at end of year | 2018-12-31 | $975,164 |
| Value of total assets at beginning of year | 2018-12-31 | $2,465,077 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $962,739 |
| Total interest from all sources | 2018-12-31 | $8,188 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $14,489 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $14,489 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $3,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $4,317,175 |
| Participant contributions at beginning of year | 2018-12-31 | $150,233 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $664,372 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $137,802 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $177,045 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $79,996 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-1,586,962 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $798,119 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $2,385,081 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $1,779,948 |
| Income. Interest from US Government securities | 2018-12-31 | $8,188 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $885,166 |
| Asset value of US Government securities at end of year | 2018-12-31 | $310,792 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $10,409,349 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $397,094 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $14,488,258 |
| Contract administrator fees | 2018-12-31 | $962,739 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | BKD, LLP |
| Accountancy firm EIN | 2018-12-31 | 440160260 |
| 2017 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $79,996 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $24,696 |
| Total income from all sources (including contributions) | 2017-12-31 | $13,932,542 |
| Total of all expenses incurred | 2017-12-31 | $13,082,393 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $12,163,606 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $13,925,416 |
| Value of total assets at end of year | 2017-12-31 | $2,465,077 |
| Value of total assets at beginning of year | 2017-12-31 | $1,559,628 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $918,787 |
| Total interest from all sources | 2017-12-31 | $747 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $6,379 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $3,823,284 |
| Participant contributions at end of year | 2017-12-31 | $150,233 |
| Participant contributions at beginning of year | 2017-12-31 | $125,190 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $137,802 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $108,551 |
| Administrative expenses (other) incurred | 2017-12-31 | $918,787 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $79,996 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $24,696 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $850,149 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $2,385,081 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,534,932 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $1,779,948 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $955,747 |
| Interest earned on other investments | 2017-12-31 | $747 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $784,683 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $10,102,132 |
| Employer contributions (assets) at end of year | 2017-12-31 | $397,094 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $370,140 |
| Income. Dividends from common stock | 2017-12-31 | $6,379 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $11,378,923 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | BKD, LLP |
| Accountancy firm EIN | 2017-12-31 | 440160260 |
| 2016 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $24,696 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $25,378 |
| Total income from all sources (including contributions) | 2016-12-31 | $12,335,623 |
| Total of all expenses incurred | 2016-12-31 | $12,204,846 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $11,357,816 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $12,334,755 |
| Value of total assets at end of year | 2016-12-31 | $1,559,628 |
| Value of total assets at beginning of year | 2016-12-31 | $1,429,533 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $847,030 |
| Total interest from all sources | 2016-12-31 | $767 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $101 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $3,119,988 |
| Participant contributions at end of year | 2016-12-31 | $125,190 |
| Participant contributions at beginning of year | 2016-12-31 | $113,662 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $108,551 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $106,073 |
| Administrative expenses (other) incurred | 2016-12-31 | $847,030 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $24,696 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $25,378 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $130,777 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $1,534,932 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,404,155 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $955,747 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $872,501 |
| Interest earned on other investments | 2016-12-31 | $767 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $583,666 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $9,214,767 |
| Employer contributions (assets) at end of year | 2016-12-31 | $370,140 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $337,297 |
| Income. Dividends from common stock | 2016-12-31 | $101 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $10,774,150 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | BKD, LLP |
| Accountancy firm EIN | 2016-12-31 | 440160260 |
| 2015 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $25,378 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $20,644 |
| Total income from all sources (including contributions) | 2015-12-31 | $12,044,437 |
| Total of all expenses incurred | 2015-12-31 | $12,421,136 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $11,611,829 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $12,043,387 |
| Value of total assets at end of year | 2015-12-31 | $1,429,533 |
| Value of total assets at beginning of year | 2015-12-31 | $1,801,498 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $809,307 |
| Total interest from all sources | 2015-12-31 | $950 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $100 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $3,042,121 |
| Participant contributions at end of year | 2015-12-31 | $113,662 |
| Participant contributions at beginning of year | 2015-12-31 | $118,541 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $106,073 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $318,779 |
| Administrative expenses (other) incurred | 2015-12-31 | $809,307 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $25,378 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $20,644 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-376,699 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $1,404,155 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,780,854 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $872,501 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $1,034,535 |
| Interest earned on other investments | 2015-12-31 | $950 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $401,205 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $9,001,266 |
| Employer contributions (assets) at end of year | 2015-12-31 | $337,297 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $329,643 |
| Income. Dividends from common stock | 2015-12-31 | $100 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $11,210,624 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
| Accountancy firm name | 2015-12-31 | BKD, LLP |
| Accountancy firm EIN | 2015-12-31 | 440160260 |
| 2014 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $20,644 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $22,440 |
| Total income from all sources (including contributions) | 2014-12-31 | $13,145,615 |
| Total of all expenses incurred | 2014-12-31 | $13,706,432 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $12,826,861 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $13,144,031 |
| Value of total assets at end of year | 2014-12-31 | $1,801,498 |
| Value of total assets at beginning of year | 2014-12-31 | $2,364,111 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $879,571 |
| Total interest from all sources | 2014-12-31 | $1,510 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $74 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $3,331,242 |
| Participant contributions at end of year | 2014-12-31 | $118,541 |
| Participant contributions at beginning of year | 2014-12-31 | $127,562 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $318,779 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $45,666 |
| Administrative expenses (other) incurred | 2014-12-31 | $879,571 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $20,644 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $22,440 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-560,817 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $1,780,854 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $2,341,671 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $1,034,535 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $1,809,445 |
| Interest earned on other investments | 2014-12-31 | $1,510 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $490,949 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $9,812,789 |
| Employer contributions (assets) at end of year | 2014-12-31 | $329,643 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $381,438 |
| Income. Dividends from common stock | 2014-12-31 | $74 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $12,335,912 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
| Accountancy firm name | 2014-12-31 | BKD, LLP |
| Accountancy firm EIN | 2014-12-31 | 440160260 |
| 2013 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $22,440 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $83,873 |
| Total income from all sources (including contributions) | 2013-12-31 | $13,551,197 |
| Total of all expenses incurred | 2013-12-31 | $12,795,049 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $12,167,063 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $13,549,277 |
| Value of total assets at end of year | 2013-12-31 | $2,364,111 |
| Value of total assets at beginning of year | 2013-12-31 | $1,669,396 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $627,986 |
| Total interest from all sources | 2013-12-31 | $1,869 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $51 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $3,513,785 |
| Participant contributions at end of year | 2013-12-31 | $127,562 |
| Participant contributions at beginning of year | 2013-12-31 | $131,890 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2013-12-31 | $281,072 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $45,666 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $133,577 |
| Administrative expenses (other) incurred | 2013-12-31 | $627,986 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $22,440 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $83,873 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $756,148 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $2,341,671 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,585,523 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $1,809,445 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $1,044,416 |
| Interest earned on other investments | 2013-12-31 | $1,869 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $440,582 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $9,754,420 |
| Employer contributions (assets) at end of year | 2013-12-31 | $381,438 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $359,513 |
| Income. Dividends from common stock | 2013-12-31 | $51 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $11,726,481 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | BKD, LLP |
| Accountancy firm EIN | 2013-12-31 | 440160260 |
| 2012 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $83,873 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $48,467 |
| Total income from all sources (including contributions) | 2012-12-31 | $12,092,377 |
| Total of all expenses incurred | 2012-12-31 | $12,490,312 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $11,933,598 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $12,086,597 |
| Value of total assets at end of year | 2012-12-31 | $1,669,396 |
| Value of total assets at beginning of year | 2012-12-31 | $2,031,925 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $556,714 |
| Total interest from all sources | 2012-12-31 | $5,747 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $33 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $3,269,462 |
| Participant contributions at end of year | 2012-12-31 | $131,890 |
| Participant contributions at beginning of year | 2012-12-31 | $5,731 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $352,453 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $133,577 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $179,494 |
| Administrative expenses (other) incurred | 2012-12-31 | $556,714 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $83,873 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $48,467 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-397,935 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $1,585,523 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $1,983,458 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $1,044,416 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $1,832,855 |
| Interest earned on other investments | 2012-12-31 | $5,747 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $474,551 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $8,464,682 |
| Employer contributions (assets) at end of year | 2012-12-31 | $359,513 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $13,845 |
| Income. Dividends from common stock | 2012-12-31 | $33 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $11,459,047 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | BKD, LLP |
| Accountancy firm EIN | 2012-12-31 | 440160260 |
| 2011 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $48,467 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $36,419 |
| Total income from all sources (including contributions) | 2011-12-31 | $9,907,610 |
| Total of all expenses incurred | 2011-12-31 | $11,803,424 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $11,270,986 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $9,891,527 |
| Value of total assets at end of year | 2011-12-31 | $2,031,925 |
| Value of total assets at beginning of year | 2011-12-31 | $3,915,691 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $532,438 |
| Total interest from all sources | 2011-12-31 | $15,985 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $98 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $2,708,232 |
| Participant contributions at end of year | 2011-12-31 | $5,731 |
| Participant contributions at beginning of year | 2011-12-31 | $13,170 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $147,227 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $179,494 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $0 |
| Administrative expenses (other) incurred | 2011-12-31 | $532,438 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $48,467 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $36,419 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-1,895,814 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $1,983,458 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $3,879,272 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $1,832,855 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $3,887,932 |
| Interest earned on other investments | 2011-12-31 | $15,985 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $862,500 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $7,036,068 |
| Employer contributions (assets) at end of year | 2011-12-31 | $13,845 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $14,589 |
| Income. Dividends from common stock | 2011-12-31 | $98 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $10,408,486 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | BKD, LLP |
| Accountancy firm EIN | 2011-12-31 | 440160260 |
| 2010 : WASHINGTON REGIONAL MEDICAL SYSTEM WELFARE BENEFIT PLAN 2010 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $36,419 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total income from all sources (including contributions) | 2010-12-31 | $10,861,048 |
| Total of all expenses incurred | 2010-12-31 | $10,809,778 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $10,019,015 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $10,837,084 |
| Value of total assets at end of year | 2010-12-31 | $3,915,691 |
| Value of total assets at beginning of year | 2010-12-31 | $3,828,002 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $790,763 |
| Total interest from all sources | 2010-12-31 | $23,791 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $173 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $2,375,436 |
| Participant contributions at end of year | 2010-12-31 | $13,170 |
| Participant contributions at beginning of year | 2010-12-31 | $11,412 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $118,443 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $6,513 |
| Administrative expenses (other) incurred | 2010-12-31 | $790,763 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $36,419 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $51,270 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $3,879,272 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $3,828,002 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $3,887,932 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $3,806,050 |
| Interest earned on other investments | 2010-12-31 | $23,791 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $565,408 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $8,343,205 |
| Employer contributions (assets) at end of year | 2010-12-31 | $14,589 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $4,027 |
| Income. Dividends from common stock | 2010-12-31 | $173 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $9,453,607 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | BKD, LLP |
| Accountancy firm EIN | 2010-12-31 | 440160260 |
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 72398-3 |
| Policy instance | 1 |
| Insurance contract or identification number | 72398-3 | | Number of Individuals Covered | 827 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $261,391 | | Total amount of fees paid to insurance company | USD $22,823 | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, HOSPITAL CONFINEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $413,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6284 | | Additional information about fees paid to insurance broker | TECHNOLOGY FEE | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $81,966 |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 000004518 |
| Policy instance | 5 |
| Insurance contract or identification number | 000004518 | | Number of Individuals Covered | 5006 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT963145 |
| Policy instance | 4 |
| Insurance contract or identification number | VDT963145 | | Number of Individuals Covered | 2922 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $12,114 | | Total amount of fees paid to insurance company | USD $5,898 | | Other welfare benefits provided | VOLUNTARY SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $180,109 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,006 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5898 | | Additional information about fees paid to insurance broker | SERIVCE FEES |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 028419 |
| Policy instance | 3 |
| Insurance contract or identification number | 028419 | | Number of Individuals Covered | 2290 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $275,415 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK966379 |
| Policy instance | 2 |
| Insurance contract or identification number | LK966379 | | Number of Individuals Covered | 875 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $38,246 | | Total amount of fees paid to insurance company | USD $18,635 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $568,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,441 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 18635 | | Additional information about fees paid to insurance broker | SERVICE FEES |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 6 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2963 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT963145 |
| Policy instance | 3 |
| Insurance contract or identification number | VDT963145 | | Number of Individuals Covered | 887 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $13,210 | | Total amount of fees paid to insurance company | USD $5,661 | | Other welfare benefits provided | VOLUNTARY SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $188,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,436 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | SERVICE FEES |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK966379 |
| Policy instance | 1 |
| Insurance contract or identification number | LK966379 | | Number of Individuals Covered | 2759 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $49,439 | | Total amount of fees paid to insurance company | USD $16,480 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $549,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,467 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | SERVICE FEES |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SHD963480 |
| Policy instance | 2 |
| Insurance contract or identification number | SHD963480 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,425 | | 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 number | 000004518 |
| Policy instance | 4 |
| Insurance contract or identification number | 000004518 | | Number of Individuals Covered | 4748 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | DJB00000T |
| Policy instance | 5 |
| Insurance contract or identification number | DJB00000T | | Number of Individuals Covered | 1857 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $91,282 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $674,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,347 | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 6 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 2211 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $273,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 7 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2919 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | LBT |
| Policy instance | 8 |
| Insurance contract or identification number | LBT | | Number of Individuals Covered | 473 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $26,873 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $230,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,060 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 000004518 |
| Policy instance | 1 |
| Insurance contract or identification number | 000004518 | | Number of Individuals Covered | 4793 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | ACCIDENT; CI |
| Policy instance | 2 |
| Insurance contract or identification number | ACCIDENT; CI | | Number of Individuals Covered | 1655 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $140,087 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT AND CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $456,858 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,990 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0 |
| Policy instance | 3 |
| Insurance contract or identification number | 0 | | Number of Individuals Covered | 2434 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $853,786 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 4 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 2194 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $273,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 5 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2750 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | LBT |
| Policy instance | 6 |
| Insurance contract or identification number | LBT | | Number of Individuals Covered | 608 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $60,856 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $319,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,254 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 7 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2560 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 8 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 935 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | HOSPITAL INDEMN |
| Policy instance | 9 |
| Insurance contract or identification number | HOSPITAL INDEMN | | Number of Individuals Covered | 555 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $8,637 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $143,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,591 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 7 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 988 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 6 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2720 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | LBT |
| Policy instance | 5 |
| Insurance contract or identification number | LBT | | Number of Individuals Covered | 785 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $328,110 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $365,321 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $98,435 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 4 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2763 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 3 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 2149 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $260,108 | | 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: 62146 ) |
| Policy contract number | ACCIDENT; CI |
| Policy instance | 2 |
| Insurance contract or identification number | ACCIDENT; CI | | Number of Individuals Covered | 1759 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $303,930 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT AND CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $434,178 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $91,157 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 000004518 |
| Policy instance | 1 |
| Insurance contract or identification number | 000004518 | | Number of Individuals Covered | 4689 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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: 62146 ) |
| Policy contract number | HOSPITAL INDEMN |
| Policy instance | 8 |
| Insurance contract or identification number | HOSPITAL INDEMN | | Number of Individuals Covered | 647 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $9,000 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $149,996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,700 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 9 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2018-09-14 | | Insurance policy end date | 2019-09-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 7 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2538 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $56,507 | | Total amount of fees paid to insurance company | USD $9,000 | | Life 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 $0 | | Amount paid for insurance broker fees | 9000 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 6 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 1000 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $50,921 | | Total amount of fees paid to insurance company | USD $5,250 | | Temporary Disability 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 $0 | | Amount paid for insurance broker fees | 5250 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 8 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2017-09-15 | | Insurance policy end date | 2018-09-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 5 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2640 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $40,967 | | Total amount of fees paid to insurance company | USD $10,750 | | Long Term Disability 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 $0 | | Amount paid for insurance broker fees | 10750 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 4 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 1934 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $16,132 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $268,869 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,132 | | Insurance broker organization code? | 3 |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | ER00003461 |
| Policy instance | 3 |
| Insurance contract or identification number | ER00003461 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $547 | | Other welfare benefits provided | ACCIDENT, CANCER, HEART, INTENSIVE | | Welfare Benefit Premiums Paid to Carrier | USD $3,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $547 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 000004518 |
| Policy instance | 2 |
| Insurance contract or identification number | 000004518 | | Number of Individuals Covered | 4473 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0378200000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0378200000 | | Number of Individuals Covered | 732 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $141,585 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $392,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $141,585 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 2 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2016-09-14 | | Insurance policy end date | 2017-09-14 | | Total amount of commissions paid to insurance broker | USD $946 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $946 | | Insurance broker organization code? | 7 | | Insurance broker name | HEALTH SPECIAL RISK INC |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 0MM112 |
| Policy instance | 3 |
| Insurance contract or identification number | 0MM112 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,014 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,148 | | Insurance broker organization code? | 3 | | Insurance broker name | TRACEY HINRICHS |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | G672472 |
| Policy instance | 4 |
| Insurance contract or identification number | G672472 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-08-01 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,276 | | 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 number | OL881 |
| Policy instance | 5 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $898 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $6,627 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $898 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INSURANCE AGENCY |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 6 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 2345 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $9,170 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $426,220 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,170 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 755559 |
| Policy instance | 7 |
| Insurance contract or identification number | 755559 | | Number of Individuals Covered | 2333 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $8,933 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability 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 $8,933 | | Insurance broker organization code? | 3 | | Insurance broker name | TRACEY HINRICHS |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 8 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 4116 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $15,052 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $242,853 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,052 | | Insurance broker organization code? | 3 | | Insurance broker name | TRACEY HINRICHS |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 03782 |
| Policy instance | 9 |
| Insurance contract or identification number | 03782 | | Number of Individuals Covered | 1303 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $79,453 | | Other welfare benefits provided | ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $218,483 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $79,453 | | Insurance broker organization code? | 3 | | Insurance broker name | TRACEY HINRICHS |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 10 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1951 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of fees paid to insurance company | USD $815,140 | | Health 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 | 815140 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BLUEADVANTAGE ADMINISTRATORS OF AR |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 4518 |
| Policy instance | 11 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 4079 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 1 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 1429 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $48,838 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $370,505 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,838 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 4922R3 |
| Policy instance | 6 |
| Insurance contract or identification number | 4922R3 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $21,044 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,833 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,044 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 8 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1649 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of fees paid to insurance company | USD $674,599 | | Health 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 | 674599 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BLUEADVANTAGE ADMINISTRATORS OF AR |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 7 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 1973 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,792 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $496,777 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,792 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 6388TI |
| Policy instance | 5 |
| Insurance contract or identification number | 6388TI | | Number of Individuals Covered | 200 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,522 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,545 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,522 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 4 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2014-09-14 | | Insurance policy end date | 2015-09-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 7 | | Insurance broker name | HEALTH SPECIAL RISK INC |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 3 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 864 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $53,377 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $430,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,377 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT HINRICHS |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 4518 |
| Policy instance | 2 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3592 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 1 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3360 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $10,833 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $181,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,833 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | OL881 |
| Policy instance | 9 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,557 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $17,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,557 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INSURANCE AGENCY |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | OL881 |
| Policy instance | 5 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $3,308 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $22,609 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,308 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INSURANCE AGENCY |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 6 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3488 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $13,158 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $205,063 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,158 | | Insurance broker organization code? | 3 | | Insurance broker name | L A BENEFIT PLANNING INC |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 7 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 2115 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $9,308 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $417,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,308 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 4922R3 |
| Policy instance | 4 |
| Insurance contract or identification number | 4922R3 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,257 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,816 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,257 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 3 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 689 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $51,246 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $407,390 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,246 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 8 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1673 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of fees paid to insurance company | USD $695,845 | | Health 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 | 695845 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BLUEADVANTAGE ADMINISTRATORS OF AR |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 6388TI |
| Policy instance | 9 |
| Insurance contract or identification number | 6388TI | | Number of Individuals Covered | 228 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $44 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 4518 |
| Policy instance | 2 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3662 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 1 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2013-09-14 | | Insurance policy end date | 2014-09-14 | | Total amount of commissions paid to insurance broker | USD $669 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,345 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $669 | | Insurance broker organization code? | 7 | | Insurance broker name | HEALTH SPECIAL RISK INC |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 4922R3 |
| Policy instance | 2 |
| Insurance contract or identification number | 4922R3 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,237 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,237 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 3 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3443 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $11,218 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $189,132 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,218 | | Insurance broker organization code? | 3 | | Insurance broker name | L A BENEFIT PLANNING INC |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 4 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 475 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $49,984 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $392,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,984 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 8 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2012-09-14 | | Insurance policy end date | 2013-09-14 | | Total amount of commissions paid to insurance broker | USD $229 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $1,145 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $229 | | Insurance broker organization code? | 7 | | Insurance broker name | HEALTH SPECIAL RISK INC |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 6 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 1989 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $9,164 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $396,086 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,164 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | 6388TI |
| Policy instance | 7 |
| Insurance contract or identification number | 6388TI | | Number of Individuals Covered | 232 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,946 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,946 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | OL881 |
| Policy instance | 9 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,934 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $27,182 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,934 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INSURANCE AGENCY |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 4518 |
| Policy instance | 1 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3587 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 5 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1637 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of fees paid to insurance company | USD $620,961 | | Health 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 | 620961 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BLUEADVANTAGE ADMINISTRATORS OF AR |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 2 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 1960 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $9,014 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $380,739 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,014 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 6388TI |
| Policy instance | 1 |
| Insurance contract or identification number | 6388TI | | Number of Individuals Covered | 269 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,481 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,962 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,481 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) |
| Policy contract number | 4518 |
| Policy instance | 3 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3530 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 4 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3305 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $10,932 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $188,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,932 | | Insurance broker organization code? | 3 | | Insurance broker name | L A BENEFIT PLANNING |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | OL881 |
| Policy instance | 5 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,576 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $32,109 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,576 | | Insurance broker organization code? | 3 | | Insurance broker name | ENTERPRISE GENERAL INSURANCE AGENCY |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 4922R3 |
| Policy instance | 6 |
| Insurance contract or identification number | 4922R3 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,391 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,642 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,391 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT W HINRICHS |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 8 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1636 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of fees paid to insurance company | USD $600,866 | | Health 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 | 600866 | | Additional information about fees paid to insurance broker | ADMINSTRATIVE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | BLUEADVANTAGE ADMINISTRATORS OF AR |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 7 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 619 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $49,433 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $385,647 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,433 | | Insurance broker organization code? | 3 | | Insurance broker name | L.A. BENEFIT PLANNING, INC. |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 6388TI |
| Policy instance | 4 |
| Insurance contract or identification number | 6388TI | | Number of Individuals Covered | 271 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $39,300 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,137 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 4922R3 |
| Policy instance | 2 |
| Insurance contract or identification number | 4922R3 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,637 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $5,196 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 8 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 647 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $48,660 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $375,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 7 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1628 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of fees paid to insurance company | USD $509,762 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 6 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3092 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $10,596 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $171,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 5 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 1883 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $9,377 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $249,760 | | 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 number | OL881 |
| Policy instance | 3 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $4,854 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $34,166 | | 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 number | 4518 |
| Policy instance | 1 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3473 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Dental Insurance Welfare Benefit | Yes | | 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 number | OL882 |
| Policy instance | 1 |
| Insurance contract or identification number | OL882 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $2,162 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | HEART & INTENSIVE | | Welfare Benefit Premiums Paid to Carrier | USD $14,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | V230112 |
| Policy instance | 2 |
| Insurance contract or identification number | V230112 | | Number of Individuals Covered | 639 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $53,009 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $434,017 | | 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 number | 4518 |
| Policy instance | 3 |
| Insurance contract or identification number | 4518 | | Number of Individuals Covered | 3348 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28419 |
| Policy instance | 5 |
| Insurance contract or identification number | 28419 | | Number of Individuals Covered | 3015 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $9,737 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $171,036 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70106 ) |
| Policy contract number | G230022 |
| Policy instance | 4 |
| Insurance contract or identification number | G230022 | | Number of Individuals Covered | 1814 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $8,397 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $256,018 | | 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 number | OL881 |
| Policy instance | 6 |
| Insurance contract or identification number | OL881 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $5,652 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | INTENSIVE, HEART, & CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $38,229 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
| Policy contract number | N/A |
| Policy instance | 7 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1617 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $478,705 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL662900 |
| Policy instance | 8 |
| Insurance contract or identification number | ABL662900 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2009-09-14 | | Insurance policy end date | 2010-09-14 | | Total amount of commissions paid to insurance broker | USD $1,295 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $6,475 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
