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UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 401k Plan overview

Plan NameUMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN
Plan identification number 501

UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

UMC PHYSICIANS has sponsored the creation of one or more 401k plans.

Company Name:UMC PHYSICIANS
Employer identification number (EIN):752646477
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01STEVEN MADDUX STEVEN MADDUX2018-09-19
5012016-01-01STEVEN MADDUX STEVEN MADDUX2017-10-13
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01JAMES COWLES
5012011-01-01
5012010-01-01
5012009-01-01
5012008-01-01
5012007-01-01
5012006-01-01
5012005-01-01
5012004-01-01
5012003-01-01
5012002-01-01
5012001-01-01
5012000-01-01
5011999-01-01
5011998-01-01
5011997-01-01

Plan Statistics for UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN

401k plan membership statisitcs for UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN

Measure Date Value
2022: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01386
Total number of active participants reported on line 7a of the Form 55002022-01-01398
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01398
2021: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01369
Total number of active participants reported on line 7a of the Form 55002021-01-01386
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01386
2020: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01379
Total number of active participants reported on line 7a of the Form 55002020-01-01369
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01369
2019: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01323
Total number of active participants reported on line 7a of the Form 55002019-01-01379
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-01380
2018: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01387
Total number of active participants reported on line 7a of the Form 55002018-01-01327
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-01328
2017: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01392
Total number of active participants reported on line 7a of the Form 55002017-01-01389
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-01390
Total participants2017-01-01390
2016: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01450
Total number of active participants reported on line 7a of the Form 55002016-01-01459
Total of all active and inactive participants2016-01-01459
Total participants2016-01-01459
2015: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01426
Total number of active participants reported on line 7a of the Form 55002015-01-01570
Total of all active and inactive participants2015-01-01570
Total participants2015-01-01570
2014: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01398
Total number of active participants reported on line 7a of the Form 55002014-01-01426
Total of all active and inactive participants2014-01-01426
Total participants2014-01-01426
2013: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01401
Total number of active participants reported on line 7a of the Form 55002013-01-01398
Total of all active and inactive participants2013-01-01398
Total participants2013-01-01398
2012: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01390
Total number of active participants reported on line 7a of the Form 55002012-01-01401
Total of all active and inactive participants2012-01-01401
Total participants2012-01-01401
2011: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01366
Total number of active participants reported on line 7a of the Form 55002011-01-01390
Total of all active and inactive participants2011-01-01390
Total participants2011-01-01390
2010: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01330
Total number of active participants reported on line 7a of the Form 55002010-01-01366
Total of all active and inactive participants2010-01-01366
Total participants2010-01-01366
2009: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01340
Total number of active participants reported on line 7a of the Form 55002009-01-01330
Total of all active and inactive participants2009-01-01330
Total participants2009-01-01330
2008: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01284
Total number of active participants reported on line 7a of the Form 55002008-01-01340
Total of all active and inactive participants2008-01-01340
Total participants2008-01-01340
2007: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01250
Total number of active participants reported on line 7a of the Form 55002007-01-01284
Total of all active and inactive participants2007-01-01284
Total participants2007-01-01284
2006: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01224
Total number of active participants reported on line 7a of the Form 55002006-01-01250
Total of all active and inactive participants2006-01-01250
Total participants2006-01-01250
2005: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01204
Total number of active participants reported on line 7a of the Form 55002005-01-01224
Total of all active and inactive participants2005-01-01224
Total participants2005-01-01224
2004: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01209
Total number of active participants reported on line 7a of the Form 55002004-01-01204
Total of all active and inactive participants2004-01-01204
Total participants2004-01-01204
2003: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01209
Total number of active participants reported on line 7a of the Form 55002003-01-01209
Total of all active and inactive participants2003-01-01209
Total participants2003-01-01209
2002: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01201
Total number of active participants reported on line 7a of the Form 55002002-01-01209
Total of all active and inactive participants2002-01-01209
Total participants2002-01-01209
2001: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01191
Total number of active participants reported on line 7a of the Form 55002001-01-01201
Total of all active and inactive participants2001-01-01201
Total participants2001-01-01201
2000: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01195
Total number of active participants reported on line 7a of the Form 55002000-01-01191
Total of all active and inactive participants2000-01-01191
Total participants2000-01-01191
1999: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01151
Total number of active participants reported on line 7a of the Form 55001999-01-01195
Total of all active and inactive participants1999-01-01195
Total participants1999-01-01195
1998: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01120
Total number of active participants reported on line 7a of the Form 55001998-01-01151
Total of all active and inactive participants1998-01-01151
Total participants1998-01-01151
1997: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-0175
Total number of active participants reported on line 7a of the Form 55001997-01-01120
Total of all active and inactive participants1997-01-01120
Total participants1997-01-01120

Form 5500 Responses for UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN

2022: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – General assets of the sponsorYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – General assets of the sponsorYes
2005: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – General assets of the sponsorYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – General assets of the sponsorYes
2004: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan funding arrangement – General assets of the sponsorYes
2004-01-01Plan benefit arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – General assets of the sponsorYes
2003: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan funding arrangement – General assets of the sponsorYes
2003-01-01Plan benefit arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – General assets of the sponsorYes
2002: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan funding arrangement – General assets of the sponsorYes
2002-01-01Plan benefit arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – General assets of the sponsorYes
2001: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan funding arrangement – General assets of the sponsorYes
2001-01-01Plan benefit arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – General assets of the sponsorYes
2000: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan funding arrangement – General assets of the sponsorYes
2000-01-01Plan benefit arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – General assets of the sponsorYes
1999: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan funding arrangement – General assets of the sponsorYes
1999-01-01Plan benefit arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – General assets of the sponsorYes
1998: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – General assets of the sponsorYes
1998-01-01Plan benefit arrangement – General assets of the sponsorYes
1997: UMC PHYSICIAN NETWORK SERVICES HEALTH AND CAFETERIA BENEFIT PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01First time form 5500 has been submittedYes
1997-01-01Submission has been amendedNo
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – General assets of the sponsorYes
1997-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103765
Policy instance 1
Insurance contract or identification number1103765
Number of Individuals Covered398
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $56,397
Total amount of fees paid to insurance companyUSD $10,817
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS/ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $425,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,691
Amount paid for insurance broker fees10817
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103765
Policy instance 1
Insurance contract or identification number1103765
Number of Individuals Covered386
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $52,778
Total amount of fees paid to insurance companyUSD $11,512
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS/ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $399,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,778
Amount paid for insurance broker fees11512
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103765
Policy instance 1
Insurance contract or identification number1103765
Number of Individuals Covered369
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $51,858
Total amount of fees paid to insurance companyUSD $20,836
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS/ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $392,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,858
Amount paid for insurance broker fees20836
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1103765
Policy instance 1
Insurance contract or identification number1103765
Number of Individuals Covered379
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $48,757
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS/ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $368,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,757
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered134
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $25,967
Total amount of fees paid to insurance companyUSD $964
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSP INT CARE-PERS REC-CANC INDEM-P
Welfare Benefit Premiums Paid to CarrierUSD $127,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,098
Amount paid for insurance broker fees63
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 2
Insurance contract or identification number731099
Number of Individuals Covered182
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,425
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,550
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number625986
Policy instance 3
Insurance contract or identification number625986
Number of Individuals Covered346
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,784
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,211
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number766276G
Policy instance 4
Insurance contract or identification number766276G
Number of Individuals Covered781
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $12,364
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPP ACCDNTL DEATH, SUPP & VOL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $115,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,701
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number625986
Policy instance 3
Insurance contract or identification number625986
Number of Individuals Covered413
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,245
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,245
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePAUL J SCIOLI
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered162
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,838
Total amount of fees paid to insurance companyUSD $170
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY, CANCER INDEMNITY, PERSONAL ACCIDENT, VOLUNTARY INDEMNITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $132,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,793
Amount paid for insurance broker fees121
Insurance broker organization code?3
Insurance broker nameRICK POLSER
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 2
Insurance contract or identification number731099
Number of Individuals Covered390
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,732
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,732
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameIRASEMA VELASQUEZ
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number766276G
Policy instance 4
Insurance contract or identification number766276G
Number of Individuals Covered763
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,722
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSUPPLEMENTAL ACCIDENTAL DEATH, SUPPLEMENTAL LIFE, VOLUNTARY LIFE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $127,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,722
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePAUL J SCIOLI
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731009
Policy instance 2
Insurance contract or identification number731009
Number of Individuals Covered213
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered176
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $34,219
Total amount of fees paid to insurance companyUSD $1,745
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $167,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameIRASEMA VELASQUEZ
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered149
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $25,915
Total amount of fees paid to insurance companyUSD $1,421
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $123,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $179
Amount paid for insurance broker fees10
Additional information about fees paid to insurance brokerSALES FEES
Insurance broker organization code?3
Insurance broker nameIRASEMA VELASQUEZ
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 2
Insurance contract or identification number731099
Number of Individuals Covered163
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,241
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,241
Insurance broker nameIRASEMA VELASQUEZ
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 2
Insurance contract or identification number731099
Number of Individuals Covered152
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered157
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $28,974
Total amount of fees paid to insurance companyUSD $342
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $133,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,497
Amount paid for insurance broker fees213
Additional information about fees paid to insurance brokerSALES FEES
Insurance broker organization code?3
Insurance broker nameMARCO JOE KLIMEK
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 2
Insurance contract or identification number731099
Number of Individuals Covered138
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered150
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $31,922
Total amount of fees paid to insurance companyUSD $1,304
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $142,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,647
Amount paid for insurance broker fees753
Additional information about fees paid to insurance brokerSALES FEES
Insurance broker organization code?3
Insurance broker nameMARCO KLIMEK
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number731099
Policy instance 1
Insurance contract or identification number731099
Number of Individuals Covered127
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered109
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $21,820
Total amount of fees paid to insurance companyUSD $1,758
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $389
Insurance broker organization code?3
Amount paid for insurance broker fees6
Additional information about fees paid to insurance brokerSALES COMMISSIONS
Insurance broker nameL. CARTHEL ENTERPRISES INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered107
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $23,260
Total amount of fees paid to insurance companyUSD $1,539
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38
Insurance broker organization code?3
Amount paid for insurance broker fees7
Additional information about fees paid to insurance brokerSALES FEE
Insurance broker nameL. CARTHEL ENTERPRISES INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered71
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $14,841
Total amount of fees paid to insurance companyUSD $549
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $237
Insurance broker organization code?3
Amount paid for insurance broker fees342
Additional information about fees paid to insurance brokerSALES FEES
Insurance broker nameL. CARTHEL ENTERPRISES INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered56
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,791
Amount paid for insurance broker fees132
Additional information about fees paid to insurance brokerSALES FEES
Insurance broker organization code?3
Insurance broker nameL. CARTHEL ENTERPRISES INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered48
Insurance policy start date2007-01-01
Insurance policy end date2007-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered46
Insurance policy start date2006-01-01
Insurance policy end date2006-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered46
Insurance policy start date2005-01-01
Insurance policy end date2005-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered48
Insurance policy start date2004-01-01
Insurance policy end date2004-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered30
Insurance policy start date2003-01-01
Insurance policy end date2003-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 2
Insurance contract or identification numberK4399
Number of Individuals Covered39
Insurance policy start date2002-01-01
Insurance policy end date2002-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered51
Insurance policy start date2001-01-01
Insurance policy end date2001-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered41
Insurance policy start date2000-01-01
Insurance policy end date2000-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberK4399
Policy instance 1
Insurance contract or identification numberK4399
Number of Individuals Covered46
Insurance policy start date1999-01-01
Insurance policy end date1999-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL INTENSIVE CARE, PERSONAL RECOVERY AND SHORT TERM DISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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