AMPAM PARKS MECHANICAL, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN
401k plan membership statisitcs for AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN
Measure | Date | Value |
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2021: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-09-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 225 |
Total of all active and inactive participants | 2021-09-01 | 225 |
2020: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-09-01 | 266 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 225 |
Total of all active and inactive participants | 2020-09-01 | 225 |
2019: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-09-01 | 186 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 266 |
Total of all active and inactive participants | 2019-09-01 | 266 |
2018: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-09-01 | 161 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 186 |
Total of all active and inactive participants | 2018-09-01 | 186 |
2017: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-09-01 | 152 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 161 |
Total of all active and inactive participants | 2017-09-01 | 161 |
2016: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-09-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 152 |
Total of all active and inactive participants | 2016-09-01 | 152 |
2015: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-09-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 127 |
Total of all active and inactive participants | 2015-09-01 | 127 |
2014: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-09-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 142 |
Total of all active and inactive participants | 2014-09-01 | 142 |
2013: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-09-01 | 121 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 147 |
Total of all active and inactive participants | 2013-09-01 | 147 |
2012: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-09-01 | 102 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 121 |
Total of all active and inactive participants | 2012-09-01 | 121 |
2011: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-09-01 | 132 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 102 |
Total of all active and inactive participants | 2011-09-01 | 102 |
2009: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-09-01 | 216 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 174 |
Total of all active and inactive participants | 2009-09-01 | 174 |
2007: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-09-01 | 237 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-09-01 | 216 |
Total of all active and inactive participants | 2007-09-01 | 216 |
Total participants | 2007-09-01 | 216 |
2006: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-09-01 | 221 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-09-01 | 237 |
Total of all active and inactive participants | 2006-09-01 | 237 |
Total participants | 2006-09-01 | 237 |
2005: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-09-01 | 0 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-09-01 | 221 |
Total of all active and inactive participants | 2005-09-01 | 221 |
Total participants | 2005-09-01 | 221 |
2021: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2021 form 5500 responses |
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2021-09-01 | Type of plan entity | Single employer plan |
2021-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-09-01 | Plan benefit arrangement – Insurance | Yes |
2020: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2020 form 5500 responses |
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2020-09-01 | Type of plan entity | Single employer plan |
2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-09-01 | Plan benefit arrangement – Insurance | Yes |
2019: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2019 form 5500 responses |
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2019-09-01 | Type of plan entity | Single employer plan |
2019-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-09-01 | Plan benefit arrangement – Insurance | Yes |
2018: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2018 form 5500 responses |
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2018-09-01 | Type of plan entity | Single employer plan |
2018-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-09-01 | Plan benefit arrangement – Insurance | Yes |
2017: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2017 form 5500 responses |
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2017-09-01 | Type of plan entity | Single employer plan |
2017-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-09-01 | Plan benefit arrangement – Insurance | Yes |
2016: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2016 form 5500 responses |
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2016-09-01 | Type of plan entity | Single employer plan |
2016-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-09-01 | Plan benefit arrangement – Insurance | Yes |
2015: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2015 form 5500 responses |
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2015-09-01 | Type of plan entity | Single employer plan |
2015-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-09-01 | Plan benefit arrangement – Insurance | Yes |
2014: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2014 form 5500 responses |
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2014-09-01 | Type of plan entity | Single employer plan |
2014-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-09-01 | Plan benefit arrangement – Insurance | Yes |
2013: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2013 form 5500 responses |
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2013-09-01 | Type of plan entity | Single employer plan |
2013-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-09-01 | Plan benefit arrangement – Insurance | Yes |
2012: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2012 form 5500 responses |
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2012-09-01 | Type of plan entity | Single employer plan |
2012-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-09-01 | Plan benefit arrangement – Insurance | Yes |
2011: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2011 form 5500 responses |
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2011-09-01 | Type of plan entity | Single employer plan |
2011-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-09-01 | Plan benefit arrangement – Insurance | Yes |
2009: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2009 form 5500 responses |
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2009-09-01 | Type of plan entity | Single employer plan |
2009-09-01 | This submission is the final filing | No |
2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-09-01 | Plan benefit arrangement – Insurance | Yes |
2007: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2007 form 5500 responses |
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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 – General assets of the sponsor | Yes |
2007-09-01 | Plan benefit arrangement – Insurance | Yes |
2006: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2006 form 5500 responses |
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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 – General assets of the sponsor | Yes |
2006-09-01 | Plan benefit arrangement – Insurance | Yes |
2005: AMPAM PARKS MECHANICAL, INC. HEALTH & WELFARE PLAN 2005 form 5500 responses |
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2005-09-01 | Type of plan entity | Single employer plan |
2005-09-01 | First time form 5500 has been submitted | Yes |
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 – General assets of the sponsor | Yes |
2005-09-01 | Plan benefit arrangement – Insurance | Yes |
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0175211HNO |
Policy instance | 2 |
Insurance contract or identification number | 0175211HNO | Number of Individuals Covered | 218 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | Total amount of commissions paid to insurance broker | USD $69,535 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,173,248 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57,714 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 618134 |
Policy instance | 1 |
Insurance contract or identification number | 618134 | Number of Individuals Covered | 935 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-09-01 | Total amount of commissions paid to insurance broker | USD $3,055 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $84,480 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,055 | Insurance broker organization code? | 3 |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0175211 |
Policy instance | 3 |
Insurance contract or identification number | 0175211 | Number of Individuals Covered | 41 | Insurance policy start date | 2022-09-01 | Insurance policy end date | 2023-08-31 | Total amount of commissions paid to insurance broker | USD $27,934 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $466,582 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,185 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 914304 |
Policy instance | 1 |
Insurance contract or identification number | 914304 | Number of Individuals Covered | 148 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $14,107 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $143,834 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,107 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 618134 |
Policy instance | 2 |
Insurance contract or identification number | 618134 | Number of Individuals Covered | 968 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $5,348 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $86,102 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,348 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 662203 |
Policy instance | 3 |
Insurance contract or identification number | 662203 | Number of Individuals Covered | 131 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $2,475 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,980 | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 476591 |
Policy instance | 4 |
Insurance contract or identification number | 476591 | Number of Individuals Covered | 85 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $4,936 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $9,129 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,527 | Insurance broker organization code? | 4 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 476592 |
Policy instance | 5 |
Insurance contract or identification number | 476592 | Number of Individuals Covered | 55 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $3,123 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ATTAINED AGE CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $13,697 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,301 | Insurance broker organization code? | 4 |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0175211HNO |
Policy instance | 6 |
Insurance contract or identification number | 0175211HNO | Number of Individuals Covered | 200 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $51,959 | Total amount of fees paid to insurance company | USD $7,500 | Welfare Benefit Premiums Paid to Carrier | USD $946,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,126 | Amount paid for insurance broker fees | 7500 | Additional information about fees paid to insurance broker | NEW BUSINESS INCENTIVE RISK | Insurance broker organization code? | 3 |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0175211 |
Policy instance | 7 |
Insurance contract or identification number | 0175211 | Number of Individuals Covered | 43 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $22,575 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $412,945 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,737 | Insurance broker organization code? | 3 |
|
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0065008 |
Policy instance | 1 |
Insurance contract or identification number | W0065008 | Number of Individuals Covered | 225 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $103,364 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,371,958 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 74466 | Additional information about fees paid to insurance broker | PRODUCER SERVICE FEES | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 914304 |
Policy instance | 2 |
Insurance contract or identification number | 914304 | Number of Individuals Covered | 106 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $11,242 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $134,236 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,242 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 618134 |
Policy instance | 3 |
Insurance contract or identification number | 618134 | Number of Individuals Covered | 1041 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $1,346 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $90,744 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,346 | Insurance broker organization code? | 3 |
|
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 662203 |
Policy instance | 4 |
Insurance contract or identification number | 662203 | Number of Individuals Covered | 121 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $3,014 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,014 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,411 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 618134 |
Policy instance | 3 |
Insurance contract or identification number | 618134 | Number of Individuals Covered | 1028 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-09-01 | Total amount of commissions paid to insurance broker | USD $3,803 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $93,054 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,803 | Insurance broker organization code? | 3 |
|
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0065008 |
Policy instance | 1 |
Insurance contract or identification number | W0065008 | Number of Individuals Covered | 266 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $110,436 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,502,449 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 79076 | Additional information about fees paid to insurance broker | PRODUCER SERVICE FEES | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 914304 |
Policy instance | 2 |
Insurance contract or identification number | 914304 | Number of Individuals Covered | 164 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $17,718 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $175,249 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,718 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 618134 |
Policy instance | 3 |
Insurance contract or identification number | 618134 | Number of Individuals Covered | 1059 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-01 | Total amount of commissions paid to insurance broker | USD $3,902 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $101,974 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,902 | Insurance broker organization code? | 3 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 914304 |
Policy instance | 2 |
Insurance contract or identification number | 914304 | Number of Individuals Covered | 166 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $17,936 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $179,357 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,936 | Insurance broker organization code? | 3 |
|
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0065008 |
Policy instance | 1 |
Insurance contract or identification number | W0065008 | Number of Individuals Covered | 276 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $100,485 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,435,506 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71,775 | Insurance broker organization code? | 3 |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 150 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $15,359 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $153,417 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 63 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $1,571 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
Policy contract number | W0065008 |
Policy instance | 3 |
Insurance contract or identification number | W0065008 | Number of Individuals Covered | 253 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2017-08-31 | Total amount of commissions paid to insurance broker | USD $87,210 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,245,849 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 127 | Insurance policy start date | 2015-09-01 | Insurance policy end date | 2016-08-31 | Total amount of commissions paid to insurance broker | USD $13,277 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $132,771 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,277 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
|
UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 91 | Insurance policy start date | 2015-09-01 | Insurance policy end date | 2016-08-31 | Total amount of commissions paid to insurance broker | USD $2,099 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,099 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0805114 |
Policy instance | 3 |
Insurance contract or identification number | 0805114 | Number of Individuals Covered | 36 | Insurance policy start date | 2015-09-01 | Insurance policy end date | 2016-08-31 | Total amount of commissions paid to insurance broker | USD $8,876 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $192,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,876 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
|
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 120 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $12,936 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $129,356 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,936 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 93 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $2,305 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,055 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,305 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 278749 |
Policy instance | 3 |
Insurance contract or identification number | 278749 | Number of Individuals Covered | 203 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $44,842 | Total amount of fees paid to insurance company | USD $4,225 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $972,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,636 | Amount paid for insurance broker fees | 4225 | Additional information about fees paid to insurance broker | INCENTIVES, EDUCATION, TRAINING | Insurance broker organization code? | 3 | Insurance broker name | ALBERT C. SIMONDS & CO |
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HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | 69551A |
Policy instance | 3 |
Insurance contract or identification number | 69551A | Number of Individuals Covered | 147 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $39,752 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $882,483 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,752 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 103 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $1,753 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,753 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 111 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $9,944 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $99,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,944 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | 69551A |
Policy instance | 3 |
Insurance contract or identification number | 69551A | Number of Individuals Covered | 121 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $36,947 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $756,031 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,947 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 70 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $7,100 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,995 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,100 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 59 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $1,284 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,840 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,284 | Insurance broker organization code? | 3 | Insurance broker name | JOHN MICHAEL MOODY |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 44 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $1,013 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,130 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 64 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $5,583 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | 69551A |
Policy instance | 3 |
Insurance contract or identification number | 69551A | Number of Individuals Covered | 102 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $25,049 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $482,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UDC DENTAL OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 52031 ) |
Policy contract number | 5298401 |
Policy instance | 1 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 24 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $600 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,999 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5298401 |
Policy instance | 2 |
Insurance contract or identification number | 5298401 | Number of Individuals Covered | 43 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $3,638 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,379 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | US392856 |
Policy instance | 3 |
Insurance contract or identification number | US392856 | Number of Individuals Covered | 132 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $16,513 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $330,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 804856 |
Policy instance | 4 |
Insurance contract or identification number | 804856 | Number of Individuals Covered | 67 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $6,395 | 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 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $120,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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