EAST TEXAS FINANCIAL CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN
401k plan membership statisitcs for EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN
Measure | Date | Value |
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2022: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 127 |
Total of all active and inactive participants | 2022-07-01 | 127 |
Total participants | 2022-07-01 | 127 |
2021: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 130 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 127 |
Total of all active and inactive participants | 2021-07-01 | 127 |
Total participants | 2021-07-01 | 127 |
2020: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 134 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 130 |
Total of all active and inactive participants | 2020-07-01 | 130 |
Total participants | 2020-07-01 | 130 |
2019: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 132 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 134 |
Total of all active and inactive participants | 2019-07-01 | 134 |
Total participants | 2019-07-01 | 134 |
2018: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 132 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 132 |
Total of all active and inactive participants | 2018-07-01 | 132 |
Total participants | 2018-07-01 | 132 |
2017: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 139 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 132 |
Total of all active and inactive participants | 2017-07-01 | 132 |
Total participants | 2017-07-01 | 132 |
2016: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 139 |
Total of all active and inactive participants | 2016-07-01 | 139 |
Total participants | 2016-07-01 | 139 |
2015: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 290 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 145 |
Total of all active and inactive participants | 2015-07-01 | 145 |
Total participants | 2015-07-01 | 0 |
2014: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 331 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 290 |
Total of all active and inactive participants | 2014-07-01 | 290 |
Total participants | 2014-07-01 | 0 |
2013: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 297 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 331 |
Total of all active and inactive participants | 2013-07-01 | 331 |
Total participants | 2013-07-01 | 0 |
2012: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 273 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 297 |
Total of all active and inactive participants | 2012-07-01 | 297 |
Total participants | 2012-07-01 | 0 |
2011: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 277 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 273 |
Total of all active and inactive participants | 2011-07-01 | 273 |
Total participants | 2011-07-01 | 273 |
2010: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-07-01 | 278 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 277 |
Total of all active and inactive participants | 2010-07-01 | 277 |
Total participants | 2010-07-01 | 277 |
2009: EAST TEXAS FINANCIAL CORP EMPLOYEE HEALTH PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 275 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 278 |
Total of all active and inactive participants | 2009-07-01 | 278 |
Total participants | 2009-07-01 | 278 |
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1129009 |
Policy instance | 3 |
Insurance contract or identification number | 1129009 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $8,693 | Total amount of fees paid to insurance company | USD $2,954 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,693 | Amount paid for insurance broker fees | 2954 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 127 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $15,096 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,396 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,096 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 213 | Insurance policy start date | 2022-07-01 | Insurance policy end date | 2023-06-30 | Total amount of commissions paid to insurance broker | USD $51,841 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,536,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,841 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1129009 |
Policy instance | 3 |
Insurance contract or identification number | 1129009 | Number of Individuals Covered | 226 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $9,294 | Total amount of fees paid to insurance company | USD $2,114 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $92,743 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,294 | Amount paid for insurance broker fees | 2114 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 115 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $14,334 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,215 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,334 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 222 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $51,841 | Total amount of fees paid to insurance company | USD $1,572 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,694,905 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,841 | Amount paid for insurance broker fees | 1572 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 223 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $52,575 | Total amount of fees paid to insurance company | USD $184 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,743,511 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,575 | Amount paid for insurance broker fees | 184 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 134 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $13,972 | Total amount of fees paid to insurance company | USD $5,460 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $108,607 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,972 | Amount paid for insurance broker fees | 5460 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1129009 |
Policy instance | 3 |
Insurance contract or identification number | 1129009 | Number of Individuals Covered | 232 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $9,628 | Total amount of fees paid to insurance company | USD $1,228 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $101,735 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,628 | Amount paid for insurance broker fees | 1228 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 240 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $63,652 | Total amount of fees paid to insurance company | USD $1,357 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,964,764 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63,652 | Amount paid for insurance broker fees | 1357 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 132 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $13,116 | Total amount of fees paid to insurance company | USD $7,840 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $101,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,116 | Amount paid for insurance broker fees | 7840 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 238 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $60,946 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,893,587 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,145 | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 134 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $15,043 | Total amount of fees paid to insurance company | USD $3,368 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $115,337 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,914 | Amount paid for insurance broker fees | 3368 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 242 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $52,886 | Total amount of fees paid to insurance company | USD $1,323 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,778,863 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F020697 |
Policy instance | 2 |
Insurance contract or identification number | F020697 | Number of Individuals Covered | 129 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $14,509 | Total amount of fees paid to insurance company | USD $5,748 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $109,697 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05928715 |
Policy instance | 3 |
Insurance contract or identification number | KM05928715 | Number of Individuals Covered | 355 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $3,505 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,764 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05928715 |
Policy instance | 4 |
Insurance contract or identification number | KM05928715 | Number of Individuals Covered | 394 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-07-01 | Total amount of commissions paid to insurance broker | USD $3,376 | Total amount of fees paid to insurance company | USD $2,217 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $96,610 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,376 | Amount paid for insurance broker fees | 2217 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 | Insurance broker name | SCOTT WARD |
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BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 ) |
Policy contract number | 327010 |
Policy instance | 3 |
Insurance contract or identification number | 327010 | Number of Individuals Covered | 273 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $1,403 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,049 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,403 | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 271 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $50,172 | Total amount of fees paid to insurance company | USD $1,530 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,690,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,172 | Amount paid for insurance broker fees | 1530 | Additional information about fees paid to insurance broker | $1,530 IN BONUS BASED ON VOLUME AND $59 IN NONMONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 230942 |
Policy instance | 2 |
Insurance contract or identification number | 230942 | Number of Individuals Covered | 119 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $6,640 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,270 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,640 | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 ) |
Policy contract number | 327010 |
Policy instance | 4 |
Insurance contract or identification number | 327010 | Number of Individuals Covered | 281 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,596 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,596 | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 230942 |
Policy instance | 3 |
Insurance contract or identification number | 230942 | Number of Individuals Covered | 129 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $16,610 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $110,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,610 | Insurance broker organization code? | 3 | Insurance broker name | RANDALL WARD |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00488892 |
Policy instance | 2 |
Insurance contract or identification number | 00488892 | Number of Individuals Covered | 154 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $11,400 | Total amount of fees paid to insurance company | USD $4,988 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $113,997 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,400 | Amount paid for insurance broker fees | 4988 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 | Insurance broker name | RANDALL WARD |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 290 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $51,979 | Total amount of fees paid to insurance company | USD $2,040 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,777,782 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,979 | Amount paid for insurance broker fees | 2040 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 ) |
Policy contract number | 327010 |
Policy instance | 2 |
Insurance contract or identification number | 327010 | Number of Individuals Covered | 168 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $1,543 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,543 | Insurance broker organization code? | 3 | Insurance broker name | THE WARD AGENCY |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 |
Policy instance | 1 |
Insurance contract or identification number | 076100 | Number of Individuals Covered | 331 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $51,007 | Total amount of fees paid to insurance company | USD $1,848 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,715,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,007 | Amount paid for insurance broker fees | 1848 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00488892 |
Policy instance | 3 |
Insurance contract or identification number | 00488892 | Number of Individuals Covered | 172 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $12,829 | Total amount of fees paid to insurance company | USD $3,173 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $128,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,829 | Amount paid for insurance broker fees | 3173 | Additional information about fees paid to insurance broker | BONUS BASED ON VOLUME | Insurance broker organization code? | 3 | Insurance broker name | RANDALL WARD |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 230942 |
Policy instance | 4 |
Insurance contract or identification number | 230942 | Number of Individuals Covered | 142 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $16,155 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,702 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,155 | Insurance broker organization code? | 3 | Insurance broker name | RANDALL WARD |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 079430 |
Policy instance | 3 |
Insurance contract or identification number | 076100 079430 | Number of Individuals Covered | 297 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $44,947 | Total amount of fees paid to insurance company | USD $3,110 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,497,671 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,947 | Amount paid for insurance broker fees | 3110 | Additional information about fees paid to insurance broker | $3,045 IN BONUS BASED ON VOLUME AND $65 IN NONMONETARY COMP | Insurance broker organization code? | 3 | Insurance broker name | RANDALL SCOTT WARD |
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SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) |
Policy contract number | 327010 |
Policy instance | 1 |
Insurance contract or identification number | 327010 | Number of Individuals Covered | 158 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $1,389 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,077 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,389 | Insurance broker name | RANDALL SCOTT WARD |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 10691 |
Policy instance | 2 |
Insurance contract or identification number | 10691 | Number of Individuals Covered | 301 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $28,307 | Total amount of fees paid to insurance company | USD $43 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $204,116 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 43 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $28,307 | Insurance broker name | RANDALL SCOTT WARD |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 076100 079430 |
Policy instance | 3 |
Insurance contract or identification number | 076100 079430 | Number of Individuals Covered | 273 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $43,072 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,435,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 10691 |
Policy instance | 2 |
Insurance contract or identification number | 10691 | Number of Individuals Covered | 145 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $30,670 | Total amount of fees paid to insurance company | USD $38 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $197,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 ) |
Policy contract number | 327010 |
Policy instance | 1 |
Insurance contract or identification number | 327010 | Number of Individuals Covered | 146 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $1,248 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | B5528 |
Policy instance | 1 |
Insurance contract or identification number | B5528 | Number of Individuals Covered | 148 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $5,060 | Total amount of fees paid to insurance company | USD $2,050 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $116,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABET |
Policy instance | 2 |
Insurance contract or identification number | G000ABET | Number of Individuals Covered | 115 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-07-01 | Total amount of commissions paid to insurance broker | USD $18,730 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $93,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0712441 |
Policy instance | 3 |
Insurance contract or identification number | 0712441 | Number of Individuals Covered | 277 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $36,111 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,252,904 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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