Logo

PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NamePCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN
Plan identification number 502

PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE 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)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PCA- PRIMARY CARE ASSOCIATES has sponsored the creation of one or more 401k plans.

Company Name:PCA- PRIMARY CARE ASSOCIATES
Employer identification number (EIN):752661960
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022016-11-01DARRELL LUMMUS DARRELL LUMMUS2018-08-13
5022015-11-01DARRELL LUMMUS DARRELL LUMMUS2018-04-26
5022014-11-01DARRELL LUMMUS DARRELL LUMMUS2016-08-17
5022013-11-01DARRELL LUMMUS DARRELL LUMMUS2015-08-17
5022012-11-01DARRELL LUMMUS DARRELL LUMMUS2014-08-14
5022011-11-01DARRELL LUMMUS DARRELL LUMMUS2013-07-24
5022009-11-01 DARRELL LUMMUS2011-08-11
5022009-11-01DARRELL LUMMUS
5022008-11-01 DARRELL LUMMUS2010-08-05

Plan Statistics for PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2016: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-018
Total number of active participants reported on line 7a of the Form 55002016-11-010
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-11-010
Total participants2016-11-010
Number of participants with account balances2016-11-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-11-010
Number of employers contributing to the scheme2016-11-010
2015: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-01205
Total number of active participants reported on line 7a of the Form 55002015-11-018
Total of all active and inactive participants2015-11-018
Total participants2015-11-018
2014: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-01207
Total number of active participants reported on line 7a of the Form 55002014-11-01204
Number of retired or separated participants receiving benefits2014-11-011
Total of all active and inactive participants2014-11-01205
Total participants2014-11-01205
2013: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-01219
Total number of active participants reported on line 7a of the Form 55002013-11-01207
Number of retired or separated participants receiving benefits2013-11-010
Number of other retired or separated participants entitled to future benefits2013-11-010
Total of all active and inactive participants2013-11-01207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-11-010
Total participants2013-11-01207
2012: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-01213
Total number of active participants reported on line 7a of the Form 55002012-11-01219
Total of all active and inactive participants2012-11-01219
Total participants2012-11-01219
2011: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-01216
Total number of active participants reported on line 7a of the Form 55002011-11-01211
Number of retired or separated participants receiving benefits2011-11-012
Total of all active and inactive participants2011-11-01213
Total participants2011-11-01213
2009: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-01224
Total number of active participants reported on line 7a of the Form 55002009-11-01240
Number of retired or separated participants receiving benefits2009-11-013
Total of all active and inactive participants2009-11-01243
Total participants2009-11-01243
2008: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-11-01212
Total number of active participants reported on line 7a of the Form 55002008-11-01224
Total of all active and inactive participants2008-11-01224
Total participants2008-11-01224

Form 5500 Responses for PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN

2016: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingYes
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan benefit arrangement – InsuranceYes
2013: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – InsuranceYes
2012: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – InsuranceYes
2011: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – InsuranceYes
2009: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes
2008: PCA-PRIMARY CARE ASSOCIATES HEALTH & WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2008-11-01Plan funding arrangement – InsuranceYes
2008-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJM
Policy instance 1
Insurance contract or identification numberG000AHJM
Number of Individuals Covered164
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $988
Total amount of fees paid to insurance companyUSD $326
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $988
Amount paid for insurance broker fees326
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number330060
Policy instance 2
Insurance contract or identification number330060
Number of Individuals Covered190
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of fees paid to insurance companyUSD $860
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees860
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberD5K18
Policy instance 3
Insurance contract or identification numberD5K18
Number of Individuals Covered21
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $10,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 4
Insurance contract or identification numberG000AHJL
Number of Individuals Covered109
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $6,901
Total amount of fees paid to insurance companyUSD $1,916
Other welfare benefits providedPREFERRED CHOICE VOLUNTARY STD
Welfare Benefit Premiums Paid to CarrierUSD $46,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,901
Amount paid for insurance broker fees1916
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 5
Insurance contract or identification numberG000AHJL
Number of Individuals Covered101
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $4,579
Total amount of fees paid to insurance companyUSD $1,372
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $30,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,579
Amount paid for insurance broker fees1372
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05995551
Policy instance 6
Insurance contract or identification numberKM05995551
Number of Individuals Covered331
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $8,412
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,412
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number053546
Policy instance 7
Insurance contract or identification number053546
Number of Individuals Covered204
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $50,428
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,296,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,889
Insurance broker organization code?3
Insurance broker nameFIRST INS AN AFFILATE OF FIRST BANK
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 6
Insurance contract or identification numberG000AHJL
Number of Individuals Covered112
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $5,819
Total amount of fees paid to insurance companyUSD $1,854
Other welfare benefits providedPREFERRED CHOICE VOLUNTARY STD
Welfare Benefit Premiums Paid to CarrierUSD $38,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,418
Amount paid for insurance broker fees1854
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJM
Policy instance 5
Insurance contract or identification numberG000AHJM
Number of Individuals Covered108
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $4,350
Total amount of fees paid to insurance companyUSD $1,431
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D-VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $29,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,859
Amount paid for insurance broker fees1431
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number330060
Policy instance 4
Insurance contract or identification number330060
Number of Individuals Covered204
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $1,362
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,362
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number53546
Policy instance 3
Insurance contract or identification number53546
Number of Individuals Covered207
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $50,464
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,288,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,464
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05995551
Policy instance 2
Insurance contract or identification numberKM05995551
Number of Individuals Covered334
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $8,498
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,498
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberD5K18
Policy instance 1
Insurance contract or identification numberD5K18
Number of Individuals Covered21
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $2,430
Total amount of fees paid to insurance companyUSD $33
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $13,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,485
Insurance broker organization code?3
Amount paid for insurance broker fees11
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker nameDAVID M COUGLIN
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 7
Insurance contract or identification numberG000AHJL
Number of Individuals Covered172
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $1,051
Total amount of fees paid to insurance companyUSD $305
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $177
Amount paid for insurance broker fees305
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameFIRST INSURANCE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05995551
Policy instance 1
Insurance contract or identification numberKM05995551
Number of Individuals Covered345
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $7,613
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,613
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJM
Policy instance 7
Insurance contract or identification numberG000AHJM
Number of Individuals Covered169
Insurance policy start date2012-11-01
Insurance policy end date2013-11-01
Total amount of commissions paid to insurance brokerUSD $942
Total amount of fees paid to insurance companyUSD $304
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $942
Amount paid for insurance broker fees304
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberD5K18
Policy instance 6
Insurance contract or identification numberD5K18
Number of Individuals Covered27
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $2,549
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $13,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,461
Insurance broker organization code?3
Insurance broker nameLARRY D DENNY
BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 )
Policy contract number330060
Policy instance 5
Insurance contract or identification number330060
Number of Individuals Covered99
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $1,321
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,321
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 4
Insurance contract or identification numberG000AHJL
Number of Individuals Covered114
Insurance policy start date2012-11-01
Insurance policy end date2013-11-01
Total amount of commissions paid to insurance brokerUSD $4,561
Total amount of fees paid to insurance companyUSD $1,375
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D-VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $30,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,561
Amount paid for insurance broker fees1375
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJL
Policy instance 3
Insurance contract or identification numberG000AHJL
Number of Individuals Covered121
Insurance policy start date2012-11-01
Insurance policy end date2013-11-01
Total amount of commissions paid to insurance brokerUSD $5,938
Total amount of fees paid to insurance companyUSD $1,748
Other welfare benefits providedSTD
Welfare Benefit Premiums Paid to CarrierUSD $39,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,938
Amount paid for insurance broker fees1748
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number053546
Policy instance 2
Insurance contract or identification number053546
Number of Individuals Covered219
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $42,426
Total amount of fees paid to insurance companyUSD $1,305
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,060,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,426
Amount paid for insurance broker fees1305
Additional information about fees paid to insurance brokerCONSULTANT FEES
Insurance broker organization code?3
Insurance broker nameINSURANCE BY DESIGN INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AHJM
Policy instance 3
Insurance contract or identification numberGLUG0AHJM
Number of Individuals Covered166
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $10,625
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D AND STD
Welfare Benefit Premiums Paid to CarrierUSD $70,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ02977
Policy instance 2
Insurance contract or identification numberGFZ02977
Number of Individuals Covered70
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $7,616
Total amount of fees paid to insurance companyUSD $148
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number053546
Policy instance 1
Insurance contract or identification number053546
Number of Individuals Covered211
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $42,383
Total amount of fees paid to insurance companyUSD $1,800
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,063,182
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 number463405
Policy instance 4
Insurance contract or identification number463405
Number of Individuals Covered109
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $1,661
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AHJM
Policy instance 4
Insurance contract or identification numberG000AHJM
Number of Individuals Covered164
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $12,996
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, STD
Welfare Benefit Premiums Paid to CarrierUSD $74,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberGFZ02977
Policy instance 3
Insurance contract or identification numberGFZ02977
Number of Individuals Covered120
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $7,281
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number053546
Policy instance 1
Insurance contract or identification number053546
Number of Individuals Covered216
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $40,812
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,023,478
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 number463405
Policy instance 2
Insurance contract or identification number463405
Number of Individuals Covered172
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $1,739
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S1