GUSTAVO JIMENEZ, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SOUTHWEST FREIGHT LINES DENTAL PLAN
| Measure | Date | Value |
|---|
| 2020: SOUTHWEST FREIGHT LINES DENTAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 111 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 111 |
| Number of employers contributing to the scheme | 2020-09-01 | 0 |
| 2019: SOUTHWEST FREIGHT LINES DENTAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 120 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 120 |
| Number of employers contributing to the scheme | 2019-09-01 | 0 |
| 2018: SOUTHWEST FREIGHT LINES DENTAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 138 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 138 |
| Number of employers contributing to the scheme | 2018-09-01 | 0 |
| 2017: SOUTHWEST FREIGHT LINES DENTAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 108 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 108 |
| Number of employers contributing to the scheme | 2017-09-01 | 0 |
| 2016: SOUTHWEST FREIGHT LINES DENTAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 204 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 204 |
| 2015: SOUTHWEST FREIGHT LINES DENTAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 155 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 155 |
| 2014: SOUTHWEST FREIGHT LINES DENTAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 126 |
| Number of retired or separated participants receiving benefits | 2014-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-09-01 | 0 |
| Total of all active and inactive participants | 2014-09-01 | 126 |
| 2013: SOUTHWEST FREIGHT LINES DENTAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 196 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 114 |
| Number of retired or separated participants receiving benefits | 2013-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-09-01 | 0 |
| Total of all active and inactive participants | 2013-09-01 | 114 |
| 2012: SOUTHWEST FREIGHT LINES DENTAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 196 |
| Number of retired or separated participants receiving benefits | 2012-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-09-01 | 0 |
| Total of all active and inactive participants | 2012-09-01 | 196 |
| 2011: SOUTHWEST FREIGHT LINES DENTAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 228 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 262 |
| Number of retired or separated participants receiving benefits | 2011-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-09-01 | 0 |
| Total of all active and inactive participants | 2011-09-01 | 262 |
| 2009: SOUTHWEST FREIGHT LINES DENTAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 218 |
| Number of retired or separated participants receiving benefits | 2009-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-09-01 | 0 |
| Total of all active and inactive participants | 2009-09-01 | 218 |
| 2008: SOUTHWEST FREIGHT LINES DENTAL PLAN 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-09-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-09-01 | 86 |
| Number of retired or separated participants receiving benefits | 2008-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-09-01 | 0 |
| Total of all active and inactive participants | 2008-09-01 | 86 |
| 2007: SOUTHWEST FREIGHT LINES DENTAL PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-09-01 | 68 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 68 |
| Number of retired or separated participants receiving benefits | 2007-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-09-01 | 0 |
| Total of all active and inactive participants | 2007-09-01 | 68 |
| 2006: SOUTHWEST FREIGHT LINES DENTAL PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-09-01 | 68 |
| Number of retired or separated participants receiving benefits | 2006-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-09-01 | 0 |
| Total of all active and inactive participants | 2006-09-01 | 68 |
| 2005: SOUTHWEST FREIGHT LINES DENTAL PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2005-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-09-01 | 0 |
| Total of all active and inactive participants | 2005-09-01 | 100 |
| 2004: SOUTHWEST FREIGHT LINES DENTAL PLAN 2004 401k membership |
|---|
| Total participants, beginning-of-year | 2004-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2004-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-09-01 | 0 |
| Total of all active and inactive participants | 2004-09-01 | 100 |
| 2003: SOUTHWEST FREIGHT LINES DENTAL PLAN 2003 401k membership |
|---|
| Total participants, beginning-of-year | 2003-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2003-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-09-01 | 0 |
| Total of all active and inactive participants | 2003-09-01 | 100 |
| 2002: SOUTHWEST FREIGHT LINES DENTAL PLAN 2002 401k membership |
|---|
| Total participants, beginning-of-year | 2002-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2002-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2002-09-01 | 0 |
| Total of all active and inactive participants | 2002-09-01 | 100 |
| 2001: SOUTHWEST FREIGHT LINES DENTAL PLAN 2001 401k membership |
|---|
| Total participants, beginning-of-year | 2001-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2001-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2001-09-01 | 0 |
| Total of all active and inactive participants | 2001-09-01 | 100 |
| 2000: SOUTHWEST FREIGHT LINES DENTAL PLAN 2000 401k membership |
|---|
| Total participants, beginning-of-year | 2000-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 2000-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2000-09-01 | 0 |
| Total of all active and inactive participants | 2000-09-01 | 100 |
| 1999: SOUTHWEST FREIGHT LINES DENTAL PLAN 1999 401k membership |
|---|
| Total participants, beginning-of-year | 1999-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1999-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1999-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1999-09-01 | 0 |
| Total of all active and inactive participants | 1999-09-01 | 100 |
| 1998: SOUTHWEST FREIGHT LINES DENTAL PLAN 1998 401k membership |
|---|
| Total participants, beginning-of-year | 1998-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1998-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1998-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1998-09-01 | 0 |
| Total of all active and inactive participants | 1998-09-01 | 100 |
| 1997: SOUTHWEST FREIGHT LINES DENTAL PLAN 1997 401k membership |
|---|
| Total participants, beginning-of-year | 1997-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1997-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1997-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1997-09-01 | 0 |
| Total of all active and inactive participants | 1997-09-01 | 100 |
| 1996: SOUTHWEST FREIGHT LINES DENTAL PLAN 1996 401k membership |
|---|
| Total participants, beginning-of-year | 1996-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1996-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1996-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1996-09-01 | 0 |
| Total of all active and inactive participants | 1996-09-01 | 100 |
| 1995: SOUTHWEST FREIGHT LINES DENTAL PLAN 1995 401k membership |
|---|
| Total participants, beginning-of-year | 1995-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1995-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1995-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1995-09-01 | 0 |
| Total of all active and inactive participants | 1995-09-01 | 100 |
| 1994: SOUTHWEST FREIGHT LINES DENTAL PLAN 1994 401k membership |
|---|
| Total participants, beginning-of-year | 1994-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1994-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1994-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1994-09-01 | 0 |
| Total of all active and inactive participants | 1994-09-01 | 100 |
| 1993: SOUTHWEST FREIGHT LINES DENTAL PLAN 1993 401k membership |
|---|
| Total participants, beginning-of-year | 1993-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1993-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1993-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1993-09-01 | 0 |
| Total of all active and inactive participants | 1993-09-01 | 100 |
| 1992: SOUTHWEST FREIGHT LINES DENTAL PLAN 1992 401k membership |
|---|
| Total participants, beginning-of-year | 1992-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 1992-09-01 | 100 |
| Number of retired or separated participants receiving benefits | 1992-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1992-09-01 | 0 |
| Total of all active and inactive participants | 1992-09-01 | 100 |
| 2020: SOUTHWEST FREIGHT LINES DENTAL PLAN 2020 form 5500 responses |
|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SOUTHWEST FREIGHT LINES DENTAL PLAN 2019 form 5500 responses |
|---|
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SOUTHWEST FREIGHT LINES DENTAL PLAN 2018 form 5500 responses |
|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SOUTHWEST FREIGHT LINES DENTAL PLAN 2017 form 5500 responses |
|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SOUTHWEST FREIGHT LINES DENTAL PLAN 2016 form 5500 responses |
|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: SOUTHWEST FREIGHT LINES DENTAL PLAN 2015 form 5500 responses |
|---|
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: SOUTHWEST FREIGHT LINES DENTAL PLAN 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Submission has been amended | No |
| 2014-09-01 | This submission is the final filing | No |
| 2014-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-09-01 | Plan is a collectively bargained plan | No |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SOUTHWEST FREIGHT LINES DENTAL PLAN 2013 form 5500 responses |
|---|
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Submission has been amended | No |
| 2013-09-01 | This submission is the final filing | No |
| 2013-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-09-01 | Plan is a collectively bargained plan | No |
| 2013-09-01 | Plan funding arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: SOUTHWEST FREIGHT LINES DENTAL PLAN 2012 form 5500 responses |
|---|
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Submission has been amended | No |
| 2012-09-01 | This submission is the final filing | No |
| 2012-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-09-01 | Plan is a collectively bargained plan | No |
| 2012-09-01 | Plan funding arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: SOUTHWEST FREIGHT LINES DENTAL PLAN 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Submission has been amended | No |
| 2011-09-01 | This submission is the final filing | No |
| 2011-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-09-01 | Plan is a collectively bargained plan | No |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SOUTHWEST FREIGHT LINES DENTAL PLAN 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Submission has been amended | No |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-09-01 | Plan is a collectively bargained plan | No |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: SOUTHWEST FREIGHT LINES DENTAL PLAN 2008 form 5500 responses |
|---|
| 2008-09-01 | Type of plan entity | Single employer plan |
| 2008-09-01 | Submission has been amended | No |
| 2008-09-01 | This submission is the final filing | No |
| 2008-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-09-01 | Plan is a collectively bargained plan | No |
| 2008-09-01 | Plan funding arrangement – Insurance | Yes |
| 2008-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: SOUTHWEST FREIGHT LINES DENTAL PLAN 2007 form 5500 responses |
|---|
| 2007-09-01 | Type of plan entity | Single employer plan |
| 2007-09-01 | Submission has been amended | No |
| 2007-09-01 | This submission is the final filing | No |
| 2007-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-09-01 | Plan is a collectively bargained plan | No |
| 2007-09-01 | Plan funding arrangement – Insurance | Yes |
| 2007-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: SOUTHWEST FREIGHT LINES DENTAL PLAN 2006 form 5500 responses |
|---|
| 2006-09-01 | Type of plan entity | Single employer plan |
| 2006-09-01 | Submission has been amended | No |
| 2006-09-01 | This submission is the final filing | No |
| 2006-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-09-01 | Plan is a collectively bargained plan | No |
| 2006-09-01 | Plan funding arrangement – Insurance | Yes |
| 2006-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: SOUTHWEST FREIGHT LINES DENTAL PLAN 2005 form 5500 responses |
|---|
| 2005-09-01 | Type of plan entity | Single employer plan |
| 2005-09-01 | Submission has been amended | No |
| 2005-09-01 | This submission is the final filing | No |
| 2005-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-09-01 | Plan is a collectively bargained plan | No |
| 2005-09-01 | Plan funding arrangement – Insurance | Yes |
| 2005-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: SOUTHWEST FREIGHT LINES DENTAL PLAN 2004 form 5500 responses |
|---|
| 2004-09-01 | Type of plan entity | Single employer plan |
| 2004-09-01 | Submission has been amended | No |
| 2004-09-01 | This submission is the final filing | No |
| 2004-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-09-01 | Plan is a collectively bargained plan | No |
| 2004-09-01 | Plan funding arrangement – Insurance | Yes |
| 2004-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: SOUTHWEST FREIGHT LINES DENTAL PLAN 2003 form 5500 responses |
|---|
| 2003-09-01 | Type of plan entity | Single employer plan |
| 2003-09-01 | Submission has been amended | No |
| 2003-09-01 | This submission is the final filing | No |
| 2003-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-09-01 | Plan is a collectively bargained plan | No |
| 2003-09-01 | Plan funding arrangement – Insurance | Yes |
| 2003-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: SOUTHWEST FREIGHT LINES DENTAL PLAN 2002 form 5500 responses |
|---|
| 2002-09-01 | Type of plan entity | Single employer plan |
| 2002-09-01 | Submission has been amended | No |
| 2002-09-01 | This submission is the final filing | No |
| 2002-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-09-01 | Plan is a collectively bargained plan | No |
| 2002-09-01 | Plan funding arrangement – Insurance | Yes |
| 2002-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: SOUTHWEST FREIGHT LINES DENTAL PLAN 2001 form 5500 responses |
|---|
| 2001-09-01 | Type of plan entity | Single employer plan |
| 2001-09-01 | Submission has been amended | No |
| 2001-09-01 | This submission is the final filing | No |
| 2001-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-09-01 | Plan is a collectively bargained plan | No |
| 2001-09-01 | Plan funding arrangement – Insurance | Yes |
| 2001-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: SOUTHWEST FREIGHT LINES DENTAL PLAN 2000 form 5500 responses |
|---|
| 2000-09-01 | Type of plan entity | Single employer plan |
| 2000-09-01 | Submission has been amended | No |
| 2000-09-01 | This submission is the final filing | No |
| 2000-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2000-09-01 | Plan is a collectively bargained plan | No |
| 2000-09-01 | Plan funding arrangement – Insurance | Yes |
| 2000-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1999: SOUTHWEST FREIGHT LINES DENTAL PLAN 1999 form 5500 responses |
|---|
| 1999-09-01 | Type of plan entity | Single employer plan |
| 1999-09-01 | Submission has been amended | No |
| 1999-09-01 | This submission is the final filing | No |
| 1999-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1999-09-01 | Plan is a collectively bargained plan | No |
| 1999-09-01 | Plan funding arrangement – Insurance | Yes |
| 1999-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1998: SOUTHWEST FREIGHT LINES DENTAL PLAN 1998 form 5500 responses |
|---|
| 1998-09-01 | Type of plan entity | Single employer plan |
| 1998-09-01 | Submission has been amended | No |
| 1998-09-01 | This submission is the final filing | No |
| 1998-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1998-09-01 | Plan is a collectively bargained plan | No |
| 1998-09-01 | Plan funding arrangement – Insurance | Yes |
| 1998-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1997: SOUTHWEST FREIGHT LINES DENTAL PLAN 1997 form 5500 responses |
|---|
| 1997-09-01 | Type of plan entity | Single employer plan |
| 1997-09-01 | Submission has been amended | No |
| 1997-09-01 | This submission is the final filing | No |
| 1997-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1997-09-01 | Plan is a collectively bargained plan | No |
| 1997-09-01 | Plan funding arrangement – Insurance | Yes |
| 1997-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1996: SOUTHWEST FREIGHT LINES DENTAL PLAN 1996 form 5500 responses |
|---|
| 1996-09-01 | Type of plan entity | Single employer plan |
| 1996-09-01 | Submission has been amended | No |
| 1996-09-01 | This submission is the final filing | No |
| 1996-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1996-09-01 | Plan is a collectively bargained plan | No |
| 1996-09-01 | Plan funding arrangement – Insurance | Yes |
| 1996-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1995: SOUTHWEST FREIGHT LINES DENTAL PLAN 1995 form 5500 responses |
|---|
| 1995-09-01 | Type of plan entity | Single employer plan |
| 1995-09-01 | Submission has been amended | No |
| 1995-09-01 | This submission is the final filing | No |
| 1995-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1995-09-01 | Plan is a collectively bargained plan | No |
| 1995-09-01 | Plan funding arrangement – Insurance | Yes |
| 1995-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1994: SOUTHWEST FREIGHT LINES DENTAL PLAN 1994 form 5500 responses |
|---|
| 1994-09-01 | Type of plan entity | Single employer plan |
| 1994-09-01 | Submission has been amended | No |
| 1994-09-01 | This submission is the final filing | No |
| 1994-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1994-09-01 | Plan is a collectively bargained plan | No |
| 1994-09-01 | Plan funding arrangement – Insurance | Yes |
| 1994-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1993: SOUTHWEST FREIGHT LINES DENTAL PLAN 1993 form 5500 responses |
|---|
| 1993-09-01 | Type of plan entity | Single employer plan |
| 1993-09-01 | Submission has been amended | No |
| 1993-09-01 | This submission is the final filing | No |
| 1993-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1993-09-01 | Plan is a collectively bargained plan | No |
| 1993-09-01 | Plan funding arrangement – Insurance | Yes |
| 1993-09-01 | Plan benefit arrangement – Insurance | Yes |
| 1992: SOUTHWEST FREIGHT LINES DENTAL PLAN 1992 form 5500 responses |
|---|
| 1992-09-01 | Type of plan entity | Single employer plan |
| 1992-09-01 | First time form 5500 has been submitted | Yes |
| 1992-09-01 | Submission has been amended | No |
| 1992-09-01 | This submission is the final filing | No |
| 1992-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1992-09-01 | Plan is a collectively bargained plan | No |
| 1992-09-01 | Plan funding arrangement – Insurance | Yes |
| 1992-09-01 | Plan benefit arrangement – Insurance | Yes |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 830054 |
| Policy instance | 1 |
| Insurance contract or identification number | 830054 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $2,481 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,307 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,481 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 830054 |
| Policy instance | 1 |
| Insurance contract or identification number | 830054 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $2,397 | | Total amount of fees paid to insurance company | USD $1,172 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,397 | | Amount paid for insurance broker fees | 1172 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | 12005811 |
| Policy instance | 1 |
| Insurance contract or identification number | 12005811 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $3,833 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,387 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $3,833 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | 12005811 |
| Policy instance | 1 |
| Insurance contract or identification number | 12005811 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $3,569 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | 12005811 |
| Policy instance | 1 |
| Insurance contract or identification number | 12005811 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2015-09-01 | | Insurance policy end date | 2016-08-31 | | Total amount of commissions paid to insurance broker | USD $4,127 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $41,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $4,127 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | 12005811 |
| Policy instance | 1 |
| Insurance contract or identification number | 12005811 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-08-31 | | Total amount of commissions paid to insurance broker | USD $4,170 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $41,704 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $4,170 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | 12005811 |
| Policy instance | 1 |
| Insurance contract or identification number | 12005811 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $2,987 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $40,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $2,987 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
| MHN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 106427 |
| Policy instance | 1 |
| Insurance contract or identification number | 106427 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $33,009 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $622,347 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $33,009 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05735915 |
| Policy instance | 1 |
| Insurance contract or identification number | KM05735915 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $2,104 | | Total amount of fees paid to insurance company | USD $615 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $35,315 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05735915 |
| Policy instance | 1 |
| Insurance contract or identification number | KM05735915 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $1,689 | | Total amount of fees paid to insurance company | USD $541 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $26,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05735915 |
| Policy instance | 1 |
| Insurance contract or identification number | KM05735915 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $1,582 | | Total amount of fees paid to insurance company | USD $493 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $26,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,582 | | Amount paid for insurance broker fees | 10 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | GAE40008 |
| Policy instance | 1 |
| Insurance contract or identification number | GAE40008 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2008-09-01 | | Insurance policy end date | 2009-08-31 | | Total amount of commissions paid to insurance broker | USD $2,291 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $28,638 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,291 | | Insurance broker organization code? | 3 | | Insurance broker name | MJ INSURANCE, INC. |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | GAE40008 |
| Policy instance | 2 |
| Insurance contract or identification number | GAE40008 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2008-02-01 | | Insurance policy end date | 2008-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2007-09-01 | | Insurance policy end date | 2008-01-31 | | Total amount of commissions paid to insurance broker | USD $359 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,201 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $359 | | Insurance broker organization code? | 3 | | Insurance broker name | COMPASS BENEFITS, INC. |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2006-09-01 | | Insurance policy end date | 2007-08-31 | | Total amount of commissions paid to insurance broker | USD $1,858 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $13,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,858 | | Insurance broker organization code? | 3 | | Insurance broker name | COMPASS BENEFITS, INC. |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2005-09-01 | | Insurance policy end date | 2006-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2004-09-01 | | Insurance policy end date | 2005-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2003-09-01 | | Insurance policy end date | 2004-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2002-09-01 | | Insurance policy end date | 2003-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2001-09-01 | | Insurance policy end date | 2002-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2000-09-01 | | Insurance policy end date | 2001-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1999-09-01 | | Insurance policy end date | 2000-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1998-09-01 | | Insurance policy end date | 1999-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1997-09-01 | | Insurance policy end date | 1998-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1996-09-01 | | Insurance policy end date | 1997-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1995-09-01 | | Insurance policy end date | 1996-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1994-09-01 | | Insurance policy end date | 1995-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1993-09-01 | | Insurance policy end date | 1994-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) |
| Policy contract number | 97059227 |
| Policy instance | 1 |
| Insurance contract or identification number | 97059227 | | Number of Individuals Covered | 100 | | Insurance policy start date | 1992-09-01 | | Insurance policy end date | 1993-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
