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PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NamePIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN
Plan identification number 502

PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

PGAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:PGAL, INC.
Employer identification number (EIN):760291476
NAIC Classification:541310
NAIC Description:Architectural Services

Additional information about PGAL, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1989-10-16
Company Identification Number: 0112993500
Legal Registered Office Address: 3131 BRIARPARK DR STE 200

HOUSTON
United States of America (USA)
77042

More information about PGAL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-08-01SHARON LANG2024-05-14
5022021-08-01QUEEN CHEVIS2023-02-27
5022020-08-01SHARON LANG2022-05-13
5022019-08-01SHARON LANG2021-04-08
5022018-08-01SHARON LANG2020-05-14
5022017-08-01
5022016-08-01
5022015-08-01SHARON LANG QUEEN CHEVIS2017-04-27
5022014-08-01SHARON LANG QUEEN CHEVIS2016-02-16
5022013-08-01SHARON LANG QUEEN CHEVIS2015-05-14
5022012-08-01SHARON LANG QUEEN CHEVIS2014-02-28
5022011-08-01SHARON LANG QUEEN CHEVIS2013-02-28
5022010-08-01SHARON LANG QUEEN CHEVIS2012-04-18
5022009-08-01SHARON LANG QUEEN CHEVIS2012-03-01
5022008-08-01SHARON LANG QUEEN CHEVIS2012-03-01
5022007-08-01SHARON LANG QUEEN CHEVIS2012-03-01

Plan Statistics for PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2022: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-08-01242
Total number of active participants reported on line 7a of the Form 55002022-08-01250
Number of retired or separated participants receiving benefits2022-08-013
Number of other retired or separated participants entitled to future benefits2022-08-010
Total of all active and inactive participants2022-08-01253
Number of employers contributing to the scheme2022-08-010
2021: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01272
Total number of active participants reported on line 7a of the Form 55002021-08-01242
Number of retired or separated participants receiving benefits2021-08-011
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01243
Number of employers contributing to the scheme2021-08-010
2020: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01261
Total number of active participants reported on line 7a of the Form 55002020-08-01272
Number of retired or separated participants receiving benefits2020-08-012
Number of other retired or separated participants entitled to future benefits2020-08-011
Total of all active and inactive participants2020-08-01275
Number of employers contributing to the scheme2020-08-010
2019: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01231
Total number of active participants reported on line 7a of the Form 55002019-08-01261
Number of retired or separated participants receiving benefits2019-08-012
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01263
Number of employers contributing to the scheme2019-08-010
2018: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01197
Total number of active participants reported on line 7a of the Form 55002018-08-01231
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-01231
Number of employers contributing to the scheme2018-08-010
2017: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01178
Total number of active participants reported on line 7a of the Form 55002017-08-01191
Number of retired or separated participants receiving benefits2017-08-010
Number of other retired or separated participants entitled to future benefits2017-08-010
Total of all active and inactive participants2017-08-01191
Number of employers contributing to the scheme2017-08-010
2016: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01137
Total number of active participants reported on line 7a of the Form 55002016-08-01174
Number of retired or separated participants receiving benefits2016-08-014
Number of other retired or separated participants entitled to future benefits2016-08-010
Total of all active and inactive participants2016-08-01178
2015: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01126
Total number of active participants reported on line 7a of the Form 55002015-08-01137
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01137
2014: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01132
Total number of active participants reported on line 7a of the Form 55002014-08-01126
Number of retired or separated participants receiving benefits2014-08-010
Number of other retired or separated participants entitled to future benefits2014-08-010
Total of all active and inactive participants2014-08-01126
2013: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01132
Total number of active participants reported on line 7a of the Form 55002013-08-01132
Number of retired or separated participants receiving benefits2013-08-010
Number of other retired or separated participants entitled to future benefits2013-08-010
Total of all active and inactive participants2013-08-01132
2012: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01133
Total number of active participants reported on line 7a of the Form 55002012-08-01132
Number of retired or separated participants receiving benefits2012-08-010
Number of other retired or separated participants entitled to future benefits2012-08-010
Total of all active and inactive participants2012-08-01132
2011: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01239
Total number of active participants reported on line 7a of the Form 55002011-08-01242
Number of retired or separated participants receiving benefits2011-08-012
Number of other retired or separated participants entitled to future benefits2011-08-010
Total of all active and inactive participants2011-08-01244
2010: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01130
Total number of active participants reported on line 7a of the Form 55002010-08-01118
Number of retired or separated participants receiving benefits2010-08-013
Number of other retired or separated participants entitled to future benefits2010-08-010
Total of all active and inactive participants2010-08-01121
2009: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01150
Total number of active participants reported on line 7a of the Form 55002009-08-01130
Number of retired or separated participants receiving benefits2009-08-010
Number of other retired or separated participants entitled to future benefits2009-08-010
Total of all active and inactive participants2009-08-01130
2008: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year2008-08-01166
Total number of active participants reported on line 7a of the Form 55002008-08-01150
Number of retired or separated participants receiving benefits2008-08-010
Number of other retired or separated participants entitled to future benefits2008-08-010
Total of all active and inactive participants2008-08-01150
2007: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2007 401k membership
Total participants, beginning-of-year2007-08-01186
Total number of active participants reported on line 7a of the Form 55002007-08-01166
Number of retired or separated participants receiving benefits2007-08-010
Number of other retired or separated participants entitled to future benefits2007-08-010
Total of all active and inactive participants2007-08-01166

Form 5500 Responses for PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN

2022: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan funding arrangement – General assets of the sponsorYes
2022-08-01Plan benefit arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – General assets of the sponsorYes
2021: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2017: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan funding arrangement – General assets of the sponsorYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – General assets of the sponsorYes
2016: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Submission has been amendedNo
2016-08-01This submission is the final filingNo
2016-08-01This return/report is a short plan year return/report (less than 12 months)No
2016-08-01Plan is a collectively bargained planNo
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Submission has been amendedNo
2015-08-01This submission is the final filingNo
2015-08-01This return/report is a short plan year return/report (less than 12 months)No
2015-08-01Plan is a collectively bargained planNo
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Submission has been amendedNo
2014-08-01This submission is the final filingNo
2014-08-01This return/report is a short plan year return/report (less than 12 months)No
2014-08-01Plan is a collectively bargained planNo
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Submission has been amendedNo
2013-08-01This submission is the final filingNo
2013-08-01This return/report is a short plan year return/report (less than 12 months)No
2013-08-01Plan is a collectively bargained planNo
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Submission has been amendedNo
2012-08-01This submission is the final filingNo
2012-08-01This return/report is a short plan year return/report (less than 12 months)No
2012-08-01Plan is a collectively bargained planNo
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Submission has been amendedNo
2011-08-01This submission is the final filingNo
2011-08-01This return/report is a short plan year return/report (less than 12 months)No
2011-08-01Plan is a collectively bargained planNo
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2010: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)No
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan funding arrangement – General assets of the sponsorYes
2010-08-01Plan benefit arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Submission has been amendedNo
2009-08-01This submission is the final filingNo
2009-08-01This return/report is a short plan year return/report (less than 12 months)No
2009-08-01Plan is a collectively bargained planNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – General assets of the sponsorYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – General assets of the sponsorYes
2008: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2008 form 5500 responses
2008-08-01Type of plan entitySingle employer plan
2008-08-01Submission has been amendedNo
2008-08-01This submission is the final filingNo
2008-08-01This return/report is a short plan year return/report (less than 12 months)No
2008-08-01Plan is a collectively bargained planNo
2008-08-01Plan funding arrangement – InsuranceYes
2008-08-01Plan funding arrangement – General assets of the sponsorYes
2008-08-01Plan benefit arrangement – InsuranceYes
2008-08-01Plan benefit arrangement – General assets of the sponsorYes
2007: PIERCE GOODWIN ALEXANDER AND LINVILLE, INC. EMPLOYEE HEALTH PLAN 2007 form 5500 responses
2007-08-01Type of plan entitySingle employer plan
2007-08-01Submission has been amendedNo
2007-08-01This submission is the final filingNo
2007-08-01This return/report is a short plan year return/report (less than 12 months)No
2007-08-01Plan is a collectively bargained planNo
2007-08-01Plan funding arrangement – InsuranceYes
2007-08-01Plan funding arrangement – General assets of the sponsorYes
2007-08-01Plan benefit arrangement – InsuranceYes
2007-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF026680
Policy instance 3
Insurance contract or identification numberF026680
Number of Individuals Covered260
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $25,957
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $185,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,957
Amount paid for insurance broker fees0
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 2
Insurance contract or identification numberRR156
Number of Individuals Covered46
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $4,842
Total amount of fees paid to insurance companyUSD $129
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER, WORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $39,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,577
Amount paid for insurance broker fees103
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number321531
Policy instance 1
Insurance contract or identification number321531
Number of Individuals Covered454
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $53,542
Total amount of fees paid to insurance companyUSD $13,010
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,843,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $53,542
Amount paid for insurance broker fees13010
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF026680
Policy instance 3
Insurance contract or identification numberF026680
Number of Individuals Covered210
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $25,787
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $205,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,787
Amount paid for insurance broker fees0
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 2
Insurance contract or identification numberRR156
Number of Individuals Covered51
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $6,292
Total amount of fees paid to insurance companyUSD $63
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER, WORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $44,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,601
Amount paid for insurance broker fees63
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number321531
Policy instance 1
Insurance contract or identification number321531
Number of Individuals Covered453
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $59,822
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,769,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $59,822
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908800
Policy instance 2
Insurance contract or identification number908800
Number of Individuals Covered670
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $19,242
Total amount of fees paid to insurance companyUSD $62,667
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,886,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,242
Amount paid for insurance broker fees62667
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 1
Insurance contract or identification numberRR156
Number of Individuals Covered59
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $6,695
Total amount of fees paid to insurance companyUSD $479
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER, WORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $50,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,205
Amount paid for insurance broker fees349
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908800
Policy instance 2
Insurance contract or identification number908800
Number of Individuals Covered507
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $26,847
Total amount of fees paid to insurance companyUSD $93,642
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,843,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,847
Amount paid for insurance broker fees93642
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 1
Insurance contract or identification numberRR156
Number of Individuals Covered61
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $11,746
Total amount of fees paid to insurance companyUSD $122
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER, WORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $55,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,332
Amount paid for insurance broker fees122
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 1
Insurance contract or identification numberRR156
Number of Individuals Covered61
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $6,630
Total amount of fees paid to insurance companyUSD $188
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER, WORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $46,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $372
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908800
Policy instance 2
Insurance contract or identification number908800
Number of Individuals Covered458
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $35,670
Total amount of fees paid to insurance companyUSD $106,157
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,609,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,670
Amount paid for insurance broker fees103973
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT BONUS
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberRR156
Policy instance 2
Insurance contract or identification numberRR156
Number of Individuals Covered56
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $7,991
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedWORKSITE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $48,242
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 number908800
Policy instance 1
Insurance contract or identification number908800
Number of Individuals Covered372
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $15,076
Total amount of fees paid to insurance companyUSD $44,930
Health Insurance Welfare BenefitYes
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 providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,625,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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