AMARILLO NATIONAL BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST
401k plan membership statisitcs for AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST
| Measure | Date | Value |
|---|
| 2022 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $781,895 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $669,333 |
| Total income from all sources (including contributions) | 2022-12-31 | $8,828,736 |
| Total of all expenses incurred | 2022-12-31 | $9,433,870 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $8,945,969 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $8,794,090 |
| Value of total assets at end of year | 2022-12-31 | $2,135,815 |
| Value of total assets at beginning of year | 2022-12-31 | $2,628,387 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $487,901 |
| Total interest from all sources | 2022-12-31 | $34,646 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Was this plan covered by a fidelity bond | 2022-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $1,115,158 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-12-31 | $1,070,245 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $53,344 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $684,063 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-605,134 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $1,353,920 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $1,959,054 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $2,082,471 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $1,944,324 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $1,944,324 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $34,646 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $496,400 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $7,678,932 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $7,379,324 |
| Contract administrator fees | 2022-12-31 | $487,901 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $781,895 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $669,333 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2022-12-31 | 463602660 |
| 2021 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $669,333 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $1,017,740 |
| Total income from all sources (including contributions) | 2021-12-31 | $8,335,978 |
| Total of all expenses incurred | 2021-12-31 | $8,411,575 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $7,913,434 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $8,335,729 |
| Value of total assets at end of year | 2021-12-31 | $2,628,387 |
| Value of total assets at beginning of year | 2021-12-31 | $3,052,391 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $498,141 |
| Total interest from all sources | 2021-12-31 | $249 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Was this plan covered by a fidelity bond | 2021-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $1,147,281 |
| Participant contributions at beginning of year | 2021-12-31 | $38,510 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-12-31 | $789,663 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $684,063 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $37,285 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-75,597 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $1,959,054 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $2,034,651 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $1,944,324 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $2,976,596 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $2,976,596 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $249 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $505,488 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $7,188,448 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $6,618,283 |
| Contract administrator fees | 2021-12-31 | $498,141 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $669,333 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $1,017,740 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2021-12-31 | 463602660 |
| 2020 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $1,017,740 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $951,606 |
| Total income from all sources (including contributions) | 2020-12-31 | $7,986,574 |
| Total of all expenses incurred | 2020-12-31 | $8,846,430 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $8,368,422 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $7,975,078 |
| Value of total assets at end of year | 2020-12-31 | $3,052,391 |
| Value of total assets at beginning of year | 2020-12-31 | $3,846,113 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $478,008 |
| Total interest from all sources | 2020-12-31 | $11,496 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Was this plan covered by a fidelity bond | 2020-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $1,009,872 |
| Participant contributions at end of year | 2020-12-31 | $38,510 |
| Participant contributions at beginning of year | 2020-12-31 | $31,788 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $37,285 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $528,517 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $-859,856 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $2,034,651 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $2,894,507 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $2,976,596 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $3,285,808 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $3,285,808 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $11,496 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $466,000 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $6,965,206 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $7,902,422 |
| Contract administrator fees | 2020-12-31 | $478,008 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $1,017,740 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $951,606 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
| Accountancy firm name | 2020-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2020-12-31 | 463602660 |
| 2019 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $951,606 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $951,606 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $191,464 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $191,464 |
| Total income from all sources (including contributions) | 2019-12-31 | $7,185,012 |
| Total income from all sources (including contributions) | 2019-12-31 | $7,185,012 |
| Total of all expenses incurred | 2019-12-31 | $6,502,803 |
| Total of all expenses incurred | 2019-12-31 | $6,502,803 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $6,255,657 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $6,255,657 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $7,126,324 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $7,126,324 |
| Value of total assets at end of year | 2019-12-31 | $3,846,113 |
| Value of total assets at end of year | 2019-12-31 | $3,846,113 |
| Value of total assets at beginning of year | 2019-12-31 | $2,403,762 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $247,146 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $247,146 |
| Total interest from all sources | 2019-12-31 | $58,688 |
| Total interest from all sources | 2019-12-31 | $58,688 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $15,000,000 |
| Value of fidelity bond cover | 2019-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $981,249 |
| Participant contributions at end of year | 2019-12-31 | $31,788 |
| Participant contributions at beginning of year | 2019-12-31 | $28,090 |
| Participant contributions at beginning of year | 2019-12-31 | $28,090 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $528,517 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $528,517 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $28,863 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $682,209 |
| Value of net income/loss | 2019-12-31 | $682,209 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $2,894,507 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $2,894,507 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $2,212,298 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $2,212,298 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $3,285,808 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $2,346,809 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $2,346,809 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $58,688 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $58,688 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $771,774 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $771,774 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $6,145,075 |
| Contributions received in cash from employer | 2019-12-31 | $6,145,075 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $5,483,883 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $5,483,883 |
| Contract administrator fees | 2019-12-31 | $247,146 |
| Contract administrator fees | 2019-12-31 | $247,146 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $951,606 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $951,606 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $191,464 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $191,464 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm name | 2019-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2019-12-31 | 463602660 |
| Accountancy firm EIN | 2019-12-31 | 463602660 |
| 2018 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $191,464 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $475,305 |
| Total income from all sources (including contributions) | 2018-12-31 | $6,545,545 |
| Total of all expenses incurred | 2018-12-31 | $6,293,102 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $5,968,745 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $6,500,799 |
| Value of total assets at end of year | 2018-12-31 | $2,403,762 |
| Value of total assets at beginning of year | 2018-12-31 | $2,435,160 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $324,357 |
| Total interest from all sources | 2018-12-31 | $44,746 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $807,706 |
| Participant contributions at end of year | 2018-12-31 | $28,090 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $28,863 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $78,878 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $252,443 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $2,212,298 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $1,959,855 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $2,346,809 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $2,356,282 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $2,356,282 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $44,746 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $792,927 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $5,693,093 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $5,175,818 |
| Contract administrator fees | 2018-12-31 | $324,357 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $191,464 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $475,305 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2018-12-31 | 463602660 |
| 2017 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $475,305 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $257,151 |
| Total income from all sources (including contributions) | 2017-12-31 | $6,332,353 |
| Total of all expenses incurred | 2017-12-31 | $5,492,703 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $5,226,178 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $6,315,494 |
| Value of total assets at end of year | 2017-12-31 | $2,435,160 |
| Value of total assets at beginning of year | 2017-12-31 | $1,377,356 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $266,525 |
| Total interest from all sources | 2017-12-31 | $16,859 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $787,008 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $78,878 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $4,565 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $839,650 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $1,959,855 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,120,205 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $2,356,282 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $1,372,791 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $1,372,791 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $16,859 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $699,619 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $5,528,486 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $4,526,559 |
| Contract administrator fees | 2017-12-31 | $266,525 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $475,305 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $257,151 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2017-12-31 | 463602660 |
| 2016 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $257,151 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $374,788 |
| Total income from all sources (including contributions) | 2016-12-31 | $6,110,296 |
| Total of all expenses incurred | 2016-12-31 | $5,925,037 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $5,551,381 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $6,106,549 |
| Value of total assets at end of year | 2016-12-31 | $1,377,356 |
| Value of total assets at beginning of year | 2016-12-31 | $1,309,734 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $373,656 |
| Total interest from all sources | 2016-12-31 | $3,747 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $13,000 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $806,530 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $4,565 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $12,988 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $185,259 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $1,120,205 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $934,946 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $1,372,791 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $1,296,746 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $1,296,746 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $3,747 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $769,604 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $5,300,019 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $4,781,777 |
| Contract administrator fees | 2016-12-31 | $360,656 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $257,151 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $374,788 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2016-12-31 | 463602660 |
| 2015 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $374,788 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $491,590 |
| Total income from all sources (including contributions) | 2015-12-31 | $5,510,050 |
| Total of all expenses incurred | 2015-12-31 | $6,112,698 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $5,752,846 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $5,507,929 |
| Value of total assets at end of year | 2015-12-31 | $1,309,734 |
| Value of total assets at beginning of year | 2015-12-31 | $2,029,184 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $359,852 |
| Total interest from all sources | 2015-12-31 | $2,121 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Administrative expenses professional fees incurred | 2015-12-31 | $13,000 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $857,917 |
| Participant contributions at beginning of year | 2015-12-31 | $26,659 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $12,988 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $67 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-602,648 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $934,946 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,537,594 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $1,296,746 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $2,002,458 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $2,002,458 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $2,121 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $848,799 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $4,650,012 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $4,904,047 |
| Contract administrator fees | 2015-12-31 | $346,852 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $374,788 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $491,590 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
| Accountancy firm name | 2015-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2015-12-31 | 463602660 |
| 2014 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $491,590 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $683,612 |
| Total income from all sources (including contributions) | 2014-12-31 | $5,015,450 |
| Total of all expenses incurred | 2014-12-31 | $5,396,394 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $5,024,585 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $5,013,810 |
| Value of total assets at end of year | 2014-12-31 | $2,029,184 |
| Value of total assets at beginning of year | 2014-12-31 | $2,602,150 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $371,809 |
| Total interest from all sources | 2014-12-31 | $1,640 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $85,566 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $753,810 |
| Participant contributions at end of year | 2014-12-31 | $26,659 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $67 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $252,925 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $48,015 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-380,944 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $1,537,594 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,918,538 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $2,002,458 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $2,349,225 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $2,349,225 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $1,640 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $783,301 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $4,260,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $4,241,284 |
| Contract administrator fees | 2014-12-31 | $286,243 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $491,590 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $635,597 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
| Accountancy firm name | 2014-12-31 | JOHNSON & SHELDON, PLLC |
| Accountancy firm EIN | 2014-12-31 | 463602660 |
| 2013 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $683,612 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $650,235 |
| Total income from all sources (including contributions) | 2013-12-31 | $4,727,902 |
| Total of all expenses incurred | 2013-12-31 | $5,103,189 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $4,899,543 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $4,726,621 |
| Value of total assets at end of year | 2013-12-31 | $2,349,350 |
| Value of total assets at beginning of year | 2013-12-31 | $2,691,260 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $203,646 |
| Total interest from all sources | 2013-12-31 | $1,281 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $27,100 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $766,621 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-12-31 | $496,202 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $125 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $13,816 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-12-31 | $48,015 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $61,636 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-375,287 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $1,665,738 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $2,041,025 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $2,349,225 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $2,677,444 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $2,677,444 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $1,281 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $955,511 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $3,960,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $3,447,830 |
| Contract administrator fees | 2013-12-31 | $176,546 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $635,597 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $588,599 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | JOHNSON & SHELDON, P.C. |
| Accountancy firm EIN | 2013-12-31 | 752569269 |
| 2012 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $650,235 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $526,939 |
| Total income from all sources (including contributions) | 2012-12-31 | $5,143,675 |
| Total of all expenses incurred | 2012-12-31 | $5,253,541 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $5,054,498 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $5,141,749 |
| Value of total assets at end of year | 2012-12-31 | $2,691,260 |
| Value of total assets at beginning of year | 2012-12-31 | $2,677,830 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $199,043 |
| Total interest from all sources | 2012-12-31 | $1,926 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $7,500 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $871,749 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-12-31 | $103,745 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $13,816 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $47 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $61,636 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $61,384 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-109,866 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $2,041,025 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $2,150,891 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $2,677,444 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $2,677,783 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $2,677,783 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $1,926 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $1,102,866 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $4,270,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $3,847,887 |
| Contract administrator fees | 2012-12-31 | $191,543 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $588,599 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $465,555 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | JOHNSON & SHELDON, P.C. |
| Accountancy firm EIN | 2012-12-31 | 752569269 |
| 2011 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $526,939 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $412,362 |
| Total income from all sources (including contributions) | 2011-12-31 | $4,405,437 |
| Total of all expenses incurred | 2011-12-31 | $4,942,020 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $4,759,970 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $4,403,026 |
| Value of total assets at end of year | 2011-12-31 | $2,677,830 |
| Value of total assets at beginning of year | 2011-12-31 | $3,099,836 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $182,050 |
| Total interest from all sources | 2011-12-31 | $2,411 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $10,300 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $15,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $767,026 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-12-31 | $519,926 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $47 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $477 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-12-31 | $61,384 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $63,634 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-536,583 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $2,150,891 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $2,687,474 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $2,677,783 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $3,099,359 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $3,099,359 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $2,411 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $1,131,409 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $3,636,000 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $3,108,635 |
| Contract administrator fees | 2011-12-31 | $171,750 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $465,555 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $348,728 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | JOHNSON & SHELDON, P.C. |
| Accountancy firm EIN | 2011-12-31 | 752569269 |
| 2010 : AMARILLO NATIONAL BANK HEALTH BENEFIT PLAN AND TRUST 2010 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $412,362 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $341,436 |
| Total income from all sources (including contributions) | 2010-12-31 | $3,869,121 |
| Total of all expenses incurred | 2010-12-31 | $3,842,828 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $3,726,045 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $3,863,697 |
| Value of total assets at end of year | 2010-12-31 | $3,099,836 |
| Value of total assets at beginning of year | 2010-12-31 | $3,002,617 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $116,783 |
| Total interest from all sources | 2010-12-31 | $5,424 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $16,000 |
| Was this plan covered by a fidelity bond | 2010-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $769,015 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2010-12-31 | $247,156 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $477 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $3,369 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2010-12-31 | $63,634 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2010-12-31 | $143,115 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $26,293 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $2,687,474 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,661,181 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $3,099,359 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $2,999,248 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $2,999,248 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $5,424 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $2,849,858 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $3,094,682 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $629,031 |
| Contract administrator fees | 2010-12-31 | $100,783 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $348,728 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $198,321 |
| Did the plan have assets held for investment | 2010-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | JOHNSON & SHELDON, P.C. |
| Accountancy firm EIN | 2010-12-31 | 752569269 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C2N9 |
| Policy instance | 3 |
| Insurance contract or identification number | G000C2N9 | | Number of Individuals Covered | 467 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $41,859 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $190,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,859 | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-057650 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-057650 | | Number of Individuals Covered | 1196 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $53,771 | | Total amount of fees paid to insurance company | USD $5,314 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $537,710 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,771 | | Amount paid for insurance broker fees | 5314 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C2N9 |
| Policy instance | 2 |
| Insurance contract or identification number | G000C2N9 | | Number of Individuals Covered | 652 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $13,403 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $60,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,403 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SRSUP |
| Policy instance | 9 |
| Insurance contract or identification number | SRSUP | | Number of Individuals Covered | 48 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,456 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $169,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,456 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C2N9 |
| Policy instance | 4 |
| Insurance contract or identification number | G000C2N9 | | Number of Individuals Covered | 652 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $13,778 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $62,628 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,778 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000C2N9 |
| Policy instance | 5 |
| Insurance contract or identification number | G000C2N9 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $16,557 | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY ONLY | | Welfare Benefit Premiums Paid to Carrier | USD $75,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,557 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 667 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $10,978 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $109,731 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,978 | | Insurance broker organization code? | 3 |
|
| BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22276 ) |
| Policy contract number | 47-MSL-000417-0 |
| Policy instance | 7 |
| Insurance contract or identification number | 47-MSL-000417-0 | | Number of Individuals Covered | 657 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | STOP LOSS | | Welfare Benefit Premiums Paid to Carrier | USD $1,091,619 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 8 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,304 | | Welfare Benefit Premiums Paid to Carrier | USD $110,932 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,304 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 1 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,348 | | Welfare Benefit Premiums Paid to Carrier | USD $117,148 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,348 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 23859 |
| Policy instance | 2 |
| Insurance contract or identification number | 23859 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,534 | | Welfare Benefit Premiums Paid to Carrier | USD $180,605 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,534 | | Insurance broker organization code? | 3 |
|
| STHEALTH/CHARTIS (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | SANB500 |
| Policy instance | 3 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $785,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | SANB500 |
| Policy instance | 4 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $11,068 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $110,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,068 | | Insurance broker organization code? | 3 |
|
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 5025 |
| Policy instance | 5 |
| Insurance contract or identification number | 5025 | | Number of Individuals Covered | 522 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $55,497 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $554,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,497 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | GF3-89046699901 |
| Policy instance | 7 |
| Insurance contract or identification number | GF3-89046699901 | | Number of Individuals Covered | 645 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $20,200 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,831 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,200 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | GD3-89046699901 |
| Policy instance | 8 |
| Insurance contract or identification number | GD3-89046699901 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $17,402 | | Other welfare benefits provided | SHORT-TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $74,145 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,402 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 9 |
| Number of Individuals Covered | 676 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $11,003 | | Other welfare benefits provided | ORGAN TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $109,959 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,003 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | SA3-89046699901 |
| Policy instance | 6 |
| Insurance contract or identification number | SA3-89046699901 | | Number of Individuals Covered | 645 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $64,250 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $269,643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,250 | | Insurance broker organization code? | 3 |
|
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 5025 |
| Policy instance | 5 |
| Insurance contract or identification number | 5025 | | Number of Individuals Covered | 523 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $45,327 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $453,270 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,327 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 1 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,692 | | Welfare Benefit Premiums Paid to Carrier | USD $122,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,692 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 23859 |
| Policy instance | 2 |
| Insurance contract or identification number | 23859 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,550 | | Welfare Benefit Premiums Paid to Carrier | USD $177,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,550 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3 89046699901 |
| Policy instance | 3 |
| Insurance contract or identification number | SA3 89046699901 | | Number of Individuals Covered | 667 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $53,366 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $265,466 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,366 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | SANB500 |
| Policy instance | 4 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $10,756 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $107,529 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,756 | | Insurance broker organization code? | 3 |
|
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | 5025 |
| Policy instance | 6 |
| Insurance contract or identification number | 5025 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $8,724 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,724 | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-202477 |
| Policy instance | 7 |
| Insurance contract or identification number | UNI-202477 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $80,710 | | Welfare Benefit Premiums Paid to Carrier | USD $672,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $80,710 | | Insurance broker organization code? | 3 |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCCLOT41184 |
| Policy instance | 8 |
| Insurance contract or identification number | HCCLOT41184 | | Number of Individuals Covered | 665 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $9,612 | | Welfare Benefit Premiums Paid to Carrier | USD $96,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,243 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GD3-89046699901 |
| Policy instance | 7 |
| Insurance contract or identification number | GD3-89046699901 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $12,059 | | Total amount of fees paid to insurance company | USD $470 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,404 | | Amount paid for insurance broker fees | 470 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-89046699901 |
| Policy instance | 6 |
| Insurance contract or identification number | GF3-89046699901 | | Number of Individuals Covered | 663 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $18,378 | | Total amount of fees paid to insurance company | USD $591 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,525 | | Amount paid for insurance broker fees | 591 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SR SUPP |
| Policy instance | 4 |
| Insurance contract or identification number | SR SUPP | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,354 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,354 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3 89046699901 |
| Policy instance | 5 |
| Insurance contract or identification number | SA3 89046699901 | | Number of Individuals Covered | 663 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $22,092 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $276,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,142 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | COMMISSIONS |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 3 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,244 | | Welfare Benefit Premiums Paid to Carrier | USD $119,716 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,244 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 1137 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $56,004 | | Total amount of fees paid to insurance company | USD $2,495 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $560,040 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,157 | | Amount paid for insurance broker fees | 2495 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SANB500 |
| Policy instance | 1 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 665 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $474,449 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | SANB500 |
| Policy instance | 9 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 665 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $10,383 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $95,676 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,013 | | Insurance broker organization code? | 3 |
|
| MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ANB |
| Policy instance | 10 |
| Insurance contract or identification number | ANB | | Number of Individuals Covered | 1301 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $20,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GD3-89046699901 |
| Policy instance | 8 |
| Insurance contract or identification number | GD3-89046699901 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $9,305 | | Total amount of fees paid to insurance company | USD $1,707 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,305 | | Amount paid for insurance broker fees | 1707 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-89046699901 |
| Policy instance | 7 |
| Insurance contract or identification number | GF3-89046699901 | | Number of Individuals Covered | 533 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $11,599 | | Total amount of fees paid to insurance company | USD $2,256 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,659 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,599 | | Amount paid for insurance broker fees | 2256 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3 89046699901 |
| Policy instance | 6 |
| Insurance contract or identification number | SA3 89046699901 | | Number of Individuals Covered | 533 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $39,995 | | Total amount of fees paid to insurance company | USD $7,643 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $198,037 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,995 | | Amount paid for insurance broker fees | 7643 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SR SUPP |
| Policy instance | 5 |
| Insurance contract or identification number | SR SUPP | | Number of Individuals Covered | 50 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,432 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $186,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,432 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | SANB500 |
| Policy instance | 4 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 536 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,769 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $93,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,769 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 3 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,280 | | Welfare Benefit Premiums Paid to Carrier | USD $128,364 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,280 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 2 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 869 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $45,744 | | Total amount of fees paid to insurance company | USD $2,318 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $457,442 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,744 | | Amount paid for insurance broker fees | 2318 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SANB500 |
| Policy instance | 1 |
| Insurance contract or identification number | SANB500 | | Number of Individuals Covered | 536 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $7,541 | | Welfare Benefit Premiums Paid to Carrier | USD $399,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,541 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-202477 |
| Policy instance | 2 |
| Insurance contract or identification number | UNI-202477 | | Number of Individuals Covered | 531 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $7,433 | | Welfare Benefit Premiums Paid to Carrier | USD $342,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,433 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 3 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 880 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $40,141 | | Total amount of fees paid to insurance company | USD $2,219 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $401,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,141 | | Amount paid for insurance broker fees | 2219 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 4 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,400 | | Welfare Benefit Premiums Paid to Carrier | USD $107,364 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,400 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FB BENEFITS GROUP |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-7573 |
| Policy instance | 5 |
| Insurance contract or identification number | 949-7573 | | Number of Individuals Covered | 531 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,858 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $83,618 | | 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 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | SR SUPP |
| Policy instance | 6 |
| Insurance contract or identification number | SR SUPP | | Number of Individuals Covered | 53 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,606 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,606 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3 89046699901 |
| Policy instance | 7 |
| Insurance contract or identification number | SA3 89046699901 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $24,604 | | Total amount of fees paid to insurance company | USD $2,802 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $111,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,604 | | Amount paid for insurance broker fees | 2802 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | DF3-89046699901 |
| Policy instance | 8 |
| Insurance contract or identification number | DF3-89046699901 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $7,921 | | Total amount of fees paid to insurance company | USD $900 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,005 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,921 | | Amount paid for insurance broker fees | 900 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GD3-89046699901 |
| Policy instance | 9 |
| Insurance contract or identification number | GD3-89046699901 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $4,830 | | Total amount of fees paid to insurance company | USD $550 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,955 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,830 | | Amount paid for insurance broker fees | 550 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
| Policy contract number | M63M44 |
| Policy instance | 1 |
| Insurance contract or identification number | M63M44 | | Number of Individuals Covered | 510 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-04-30 | | Total amount of commissions paid to insurance broker | USD $18,489 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (SPECIFY)- AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $84,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,489 | | Additional information about fees paid to insurance broker | SERVICE FEE | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA- BRYSON BENEFITS GROUP |
|
| UNITED HEALTHCARE OF TEXAS INC. (National Association of Insurance Commissioners NAIC id number: 95765 ) |
| Policy contract number | SR SUPP |
| Policy instance | 9 |
| Insurance contract or identification number | SR SUPP | | Number of Individuals Covered | 57 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,960 | | Welfare Benefit Premiums Paid to Carrier | USD $172,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,960 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 8 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,559 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 7 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 505 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $13,180 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,180 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA-BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 505 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,169 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,950 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,169 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-7573 |
| Policy instance | 6 |
| Insurance contract or identification number | 949-7573 | | Number of Individuals Covered | 515 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,872 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $93,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,872 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 505 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $30,130 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $137,476 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,130 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 5 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,960 | | Welfare Benefit Premiums Paid to Carrier | USD $111,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,960 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 4 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 880 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $39,342 | | Total amount of fees paid to insurance company | USD $1,084 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $393,425 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,342 | | Amount paid for insurance broker fees | 1084 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLI 50,687 |
| Policy instance | 3 |
| Insurance contract or identification number | CLI 50,687 | | Number of Individuals Covered | 521 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $7,485 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $374,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,485 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 7 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $12,575 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,160 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,575 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA-BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 8 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,824 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 949-7573 |
| Policy instance | 6 |
| Insurance contract or identification number | 949-7573 | | Number of Individuals Covered | 521 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of fees paid to insurance company | USD $31,242 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $92,713 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 31242 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | S5820 |
| Policy instance | 5 |
| Insurance contract or identification number | S5820 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $93,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 4 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 818 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $35,370 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $353,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,370 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | CLI 50,687 |
| Policy instance | 3 |
| Insurance contract or identification number | CLI 50,687 | | Number of Individuals Covered | 521 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of fees paid to insurance company | USD $124,531 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $369,554 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 124531 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $29,624 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $135,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,624 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,132 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,132 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| UNITED HEALTHCARE OF TEXAS INC. (National Association of Insurance Commissioners NAIC id number: 95765 ) |
| Policy contract number | SR SUPP |
| Policy instance | 9 |
| Insurance contract or identification number | SR SUPP | | Number of Individuals Covered | 52 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $144,884 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,907 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,907 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 8 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 7 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $12,103 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,103 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA-BRYSON |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | S500500 |
| Policy instance | 6 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $6,318 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $63,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,159 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | IMS |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-039257 |
| Policy instance | 4 |
| Insurance contract or identification number | 010-039257 | | Number of Individuals Covered | 803 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $35,097 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $350,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,097 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | S500500 |
| Policy instance | 3 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of fees paid to insurance company | USD $100,810 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $296,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 100639 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | IMS |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $27,635 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,635 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ANB |
| Policy instance | 5 |
| Insurance contract or identification number | ANB | | Number of Individuals Covered | 1077 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $21,122 | | Welfare Benefit Premiums Paid to Carrier | USD $19,419 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,122 | | Additional information about fees paid to insurance broker | COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | FUQUA-BRYSON BENEFITS GROUP |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 486 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,891 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,891 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 486 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $27,674 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,674 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | S500500 |
| Policy instance | 3 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 541 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $68,496 | | Total amount of fees paid to insurance company | USD $80,196 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $456,894 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,651 | | Amount paid for insurance broker fees | 80196 | | Additional information about fees paid to insurance broker | REINSURANCE FEES | | Insurance broker organization code? | 3 | | Insurance broker name | IMS |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5447821 |
| Policy instance | 4 |
| Insurance contract or identification number | 5447821 | | Number of Individuals Covered | 366 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $35,363 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $323,306 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,363 | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA BRYSON |
|
| MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ANB |
| Policy instance | 5 |
| Insurance contract or identification number | ANB | | Number of Individuals Covered | 1094 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $26,028 | | Welfare Benefit Premiums Paid to Carrier | USD $19,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,028 | | Additional information about fees paid to insurance broker | COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | NEELY CRAIG & WATSON, LLP |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | S500500 |
| Policy instance | 6 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 541 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $7,886 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $78,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,943 | | Additional information about fees paid to insurance broker | INSURANCE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | IMS |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 7 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 486 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $11,767 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,767 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | MICHELLE FUQUA-BRYSON |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 8 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,458 | | 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 | 5447821 |
| Policy instance | 4 |
| Insurance contract or identification number | 5447821 | | Number of Individuals Covered | 373 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $32,537 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $327,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $27,946 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $127,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 8 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,904 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 7 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $11,571 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,594 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | S500500 |
| Policy instance | 6 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 550 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,432 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $74,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ANB |
| Policy instance | 5 |
| Insurance contract or identification number | ANB | | Number of Individuals Covered | 1123 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $25,936 | | Welfare Benefit Premiums Paid to Carrier | USD $19,932 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | S500500 |
| Policy instance | 3 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 546 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $62,981 | | Total amount of fees paid to insurance company | USD $87,903 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $449,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 488 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,809 | | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,316 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | S500500 |
| Policy instance | 7 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,264 | | Other welfare benefits provided | TRANSPLANT POLICY | | Welfare Benefit Premiums Paid to Carrier | USD $12,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 ) |
| Policy contract number | S500500 |
| Policy instance | 1 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 469 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of fees paid to insurance company | USD $135,361 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $793,983 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 964960 |
| Policy instance | 2 |
| Insurance contract or identification number | OK 964960 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $3,384 | | Total amount of fees paid to insurance company | USD $471 | | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $15,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX963308 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX963308 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $24,007 | | Total amount of fees paid to insurance company | USD $3,850 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | S500500 |
| Policy instance | 4 |
| Insurance contract or identification number | S500500 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $19,721 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MAXORPLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | ANB |
| Policy instance | 6 |
| Insurance contract or identification number | ANB | | Number of Individuals Covered | 874 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $21,665 | | Welfare Benefit Premiums Paid to Carrier | USD $648,327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12331336 |
| Policy instance | 9 |
| Insurance contract or identification number | 12331336 | | Number of Individuals Covered | 306 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,833 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,476 | | 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 | 5447821 |
| Policy instance | 5 |
| Insurance contract or identification number | 5447821 | | Number of Individuals Covered | 369 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $16,720 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $238,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | VDT960594 |
| Policy instance | 10 |
| Insurance contract or identification number | VDT960594 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of fees paid to insurance company | USD $573 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 962374 |
| Policy instance | 8 |
| Insurance contract or identification number | LK 962374 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $10,262 | | Total amount of fees paid to insurance company | USD $1,211 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
