FASKEN OIL & RANCH, LTD has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN
401k plan membership statisitcs for FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2023: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 166 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 166 |
| 2022: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 167 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 167 |
| Total participants | 2022-01-01 | 281 |
| 2021: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 136 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 136 |
| Total participants | 2021-01-01 | 262 |
| 2020: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 148 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 148 |
| Total participants | 2020-01-01 | 255 |
| 2019: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 128 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 128 |
| Total participants | 2019-01-01 | 259 |
| 2018: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 111 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 111 |
| Total participants | 2018-01-01 | 254 |
| 2017: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 104 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 104 |
| Total participants | 2017-01-01 | 234 |
| 2016: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 224 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 234 |
| Total of all active and inactive participants | 2016-01-01 | 234 |
| Total participants | 2016-01-01 | 234 |
| 2015: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 224 |
| Total of all active and inactive participants | 2015-01-01 | 224 |
| Total participants | 2015-01-01 | 0 |
| 2014: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 226 |
| Total of all active and inactive participants | 2014-01-01 | 226 |
| Total participants | 2014-01-01 | 0 |
| 2013: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 213 |
| Total of all active and inactive participants | 2013-01-01 | 213 |
| Total participants | 2013-01-01 | 0 |
| 2012: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 354 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 330 |
| Total of all active and inactive participants | 2012-01-01 | 330 |
| Total participants | 2012-01-01 | 0 |
| 2011: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 144 |
| Total of all active and inactive participants | 2011-01-01 | 144 |
| Total participants | 2011-01-01 | 144 |
| 2010: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 138 |
| Total of all active and inactive participants | 2010-01-01 | 138 |
| Total participants | 2010-01-01 | 138 |
| 2009: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 129 |
| Total of all active and inactive participants | 2009-01-01 | 129 |
| Total participants | 2009-01-01 | 129 |
| 2023: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: FASKEN OIL & RANCH, LTD. EMPLOYEE MEDICAL PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | First time form 5500 has been submitted | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL 900001302 |
| Policy instance | 2 |
| Insurance contract or identification number | ESL 900001302 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,664,272 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 935042 |
| Policy instance | 1 |
| Insurance contract or identification number | 935042 | | Number of Individuals Covered | 276 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $166,254 | | Total amount of fees paid to insurance company | USD $8,042 | | Dental Insurance Welfare Benefit | Yes | | Vision 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 | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $1,224,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $166,254 | | Amount paid for insurance broker fees | 8042 | | Additional information about fees paid to insurance broker | BONUSES PRO-RATED BASED ON PREMIUMS | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL 900001301 |
| Policy instance | 2 |
| Insurance contract or identification number | ESL 900001301 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,358,954 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 935042 |
| Policy instance | 1 |
| Insurance contract or identification number | 935042 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $138,492 | | Total amount of fees paid to insurance company | USD $7,706 | | Dental Insurance Welfare Benefit | Yes | | Vision 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 | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $962,083 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $138,492 | | Amount paid for insurance broker fees | 7706 | | Additional information about fees paid to insurance broker | BONUSES PRO-RATED BASED ON PREMIUMS | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL 900001301 |
| Policy instance | 2 |
| Insurance contract or identification number | ESL 900001301 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,306,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 935042 |
| Policy instance | 1 |
| Insurance contract or identification number | 935042 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $127,701 | | Total amount of fees paid to insurance company | USD $6,797 | | Dental Insurance Welfare Benefit | Yes | | Vision 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 | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $896,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $127,701 | | Amount paid for insurance broker fees | 6797 | | Additional information about fees paid to insurance broker | BONUSES PRO-RATED BASED ON PREMIUMS | | Insurance broker organization code? | 3 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467653 |
| Policy instance | 1 |
| Insurance contract or identification number | 5467653 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $116,857 | | Total amount of fees paid to insurance company | USD $20,466 | | Dental Insurance Welfare Benefit | Yes | | 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 $843,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $116,857 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 20466 | | Additional information about fees paid to insurance broker | BONUS COMMISSIONS |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 4053950 |
| Policy instance | 2 |
| Insurance contract or identification number | 4053950 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $13,236 | | Other welfare benefits provided | ACCIDENT AND CANCER INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $50,996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,236 | | Insurance broker organization code? | 3 |
|
| WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
| Policy contract number | ESL 900001300 |
| Policy instance | 3 |
| Insurance contract or identification number | ESL 900001300 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,183,679 | | 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 | |
| Policy instance | 3 |
| Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Other welfare benefits provided | TRANSPLANT INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $46,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 3086 ) |
| Policy contract number | UNI-202254 |
| Policy instance | 2 |
| Insurance contract or identification number | UNI-202254 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $185,630 | | Welfare Benefit Premiums Paid to Carrier | USD $836,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $143,824 | | Insurance broker organization code? | 3 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467653 |
| Policy instance | 1 |
| Insurance contract or identification number | 5467653 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $112,916 | | Total amount of fees paid to insurance company | USD $6,894 | | Dental Insurance Welfare Benefit | Yes | | 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 $813,225 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $112,916 | | Amount paid for insurance broker fees | 6894 | | Additional information about fees paid to insurance broker | BONUS COMMISSIONS | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 947-4307 |
| Policy instance | 4 |
| Insurance contract or identification number | 947-4307 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Other welfare benefits provided | TRANSPLANT INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $45,476 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AIG MEDICAL EXCESS (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | 405365 |
| Policy instance | 3 |
| Insurance contract or identification number | 405365 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $37,821 | | 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 | UNI-202254 |
| Policy instance | 2 |
| Insurance contract or identification number | UNI-202254 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-01-01 | | Total amount of commissions paid to insurance broker | USD $111,664 | | Welfare Benefit Premiums Paid to Carrier | USD $624,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $109,416 | | Insurance broker organization code? | 3 | | Insurance broker name | TTD CORPORATION |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5467653 |
| Policy instance | 1 |
| Insurance contract or identification number | 5467653 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $105,671 | | Dental Insurance Welfare Benefit | Yes | | 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 $756,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $105,671 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
