MEDICAL CLINIC OF HOUSTON, LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D
| Measure | Date | Value |
|---|
| 2022: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 267 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 258 |
| Total of all active and inactive participants | 2022-01-01 | 258 |
| 2021: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 267 |
| Total of all active and inactive participants | 2021-01-01 | 267 |
| 2020: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 265 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 266 |
| Total of all active and inactive participants | 2020-01-01 | 266 |
| 2019: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 276 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 265 |
| Total of all active and inactive participants | 2019-01-01 | 265 |
| 2018: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 259 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 276 |
| Total of all active and inactive participants | 2018-01-01 | 276 |
| 2017: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 251 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 259 |
| Total of all active and inactive participants | 2017-01-01 | 259 |
| 2016: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 237 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 251 |
| Total of all active and inactive participants | 2016-01-01 | 251 |
| 2015: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 237 |
| Total of all active and inactive participants | 2015-01-01 | 237 |
| 2014: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 236 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 228 |
| Total of all active and inactive participants | 2014-01-01 | 228 |
| 2013: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 243 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 236 |
| Total of all active and inactive participants | 2013-01-01 | 236 |
| 2012: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 243 |
| Total of all active and inactive participants | 2012-01-01 | 243 |
| 2011: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 261 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 247 |
| Total of all active and inactive participants | 2011-01-01 | 247 |
| 2009: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 229 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 242 |
| Total of all active and inactive participants | 2009-01-01 | 242 |
| 2022: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: MEDICAL CLINIC OF HOUSTON TERM LIFE AD&D 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 258 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $7,151 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,134 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,151 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 258 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $462 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,621 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $462 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 267 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $4,046 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,461 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,213 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 267 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $368 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $368 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 266 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $4,230 | | Total amount of fees paid to insurance company | USD $68 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,301 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,230 | | Amount paid for insurance broker fees | 68 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 266 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $385 | | Total amount of fees paid to insurance company | USD $68 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,845 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $385 | | Amount paid for insurance broker fees | 68 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 265 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $376 | | Total amount of fees paid to insurance company | USD $113 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $376 | | Amount paid for insurance broker fees | 113 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 265 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $4,137 | | Total amount of fees paid to insurance company | USD $113 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,370 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,137 | | Amount paid for insurance broker fees | 113 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 276 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $4,103 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,103 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 276 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $373 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,730 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $373 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 259 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $3,928 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,281 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,928 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 259 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $357 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $357 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 237 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $3,457 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,575 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,457 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 237 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $314 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,143 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $314 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 228 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $3,719 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,719 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 228 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $465 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $465 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 236 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $464 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | 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 $464 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 236 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $3,714 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,714 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 243 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $3,875 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,875 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 243 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $484 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $484 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 1 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 247 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $492 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 767370G |
| Policy instance | 2 |
| Insurance contract or identification number | 767370G | | Number of Individuals Covered | 247 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $3,935 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,349 | | 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 | 640876 |
| Policy instance | 1 |
| Insurance contract or identification number | 640876 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2009-08-01 | | Insurance policy end date | 2010-07-31 | | Total amount of commissions paid to insurance broker | USD $3,143 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $3,143 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 640876 |
| Policy instance | 2 |
| Insurance contract or identification number | 640876 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2010-10-31 | | Total amount of commissions paid to insurance broker | USD $1,180 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $1,180 | | Insurance broker organization code? | 3 | | Insurance broker name | IMG BENEFITS GROUP LLC |
|
