ROCKET BALL LTD. has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2022: ROCKET BALL, LTD 2022 401k membership |
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Total participants, beginning-of-year | 2022-02-01 | 183 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 219 |
Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
Total of all active and inactive participants | 2022-02-01 | 219 |
Number of employers contributing to the scheme | 2022-02-01 | 0 |
2021: ROCKET BALL, LTD 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-02-01 | 187 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 183 |
Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
Total of all active and inactive participants | 2021-02-01 | 183 |
Number of employers contributing to the scheme | 2021-02-01 | 0 |
2020: ROCKET BALL, LTD 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-02-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 187 |
Number of retired or separated participants receiving benefits | 2020-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-02-01 | 0 |
Total of all active and inactive participants | 2020-02-01 | 187 |
Number of employers contributing to the scheme | 2020-02-01 | 0 |
2019: ROCKET BALL, LTD 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-02-01 | 217 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 195 |
Number of retired or separated participants receiving benefits | 2019-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-02-01 | 0 |
Total of all active and inactive participants | 2019-02-01 | 195 |
Number of employers contributing to the scheme | 2019-02-01 | 0 |
2018: ROCKET BALL, LTD 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-02-01 | 201 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 217 |
Number of retired or separated participants receiving benefits | 2018-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
Total of all active and inactive participants | 2018-02-01 | 217 |
Number of employers contributing to the scheme | 2018-02-01 | 0 |
2017: ROCKET BALL, LTD 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-02-01 | 187 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 201 |
Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
Total of all active and inactive participants | 2017-02-01 | 201 |
2016: ROCKET BALL, LTD 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-02-01 | 196 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 181 |
Number of retired or separated participants receiving benefits | 2016-02-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
Total of all active and inactive participants | 2016-02-01 | 187 |
2015: ROCKET BALL, LTD 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-02-01 | 210 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 210 |
Number of retired or separated participants receiving benefits | 2015-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
Total of all active and inactive participants | 2015-02-01 | 210 |
2014: ROCKET BALL, LTD 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-02-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 210 |
Number of retired or separated participants receiving benefits | 2014-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-02-01 | 0 |
Total of all active and inactive participants | 2014-02-01 | 210 |
2013: ROCKET BALL, LTD 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-02-01 | 197 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 205 |
Number of retired or separated participants receiving benefits | 2013-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-02-01 | 0 |
Total of all active and inactive participants | 2013-02-01 | 205 |
2012: ROCKET BALL, LTD 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-02-01 | 185 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 197 |
Number of retired or separated participants receiving benefits | 2012-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-02-01 | 0 |
Total of all active and inactive participants | 2012-02-01 | 197 |
2011: ROCKET BALL, LTD 2011 401k membership |
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Total participants, beginning-of-year | 2011-02-01 | 207 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 185 |
Number of retired or separated participants receiving benefits | 2011-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-02-01 | 0 |
Total of all active and inactive participants | 2011-02-01 | 185 |
2010: ROCKET BALL, LTD 2010 401k membership |
---|
Total participants, beginning-of-year | 2010-02-01 | 208 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-02-01 | 207 |
Number of retired or separated participants receiving benefits | 2010-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-02-01 | 0 |
Total of all active and inactive participants | 2010-02-01 | 207 |
2009: ROCKET BALL, LTD 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-02-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 208 |
Number of retired or separated participants receiving benefits | 2009-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-02-01 | 0 |
Total of all active and inactive participants | 2009-02-01 | 208 |
2008: ROCKET BALL, LTD 2008 401k membership |
---|
Total participants, beginning-of-year | 2008-02-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-02-01 | 199 |
Number of retired or separated participants receiving benefits | 2008-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-02-01 | 0 |
Total of all active and inactive participants | 2008-02-01 | 199 |
2022: ROCKET BALL, LTD 2022 form 5500 responses |
---|
2022-02-01 | Type of plan entity | Multi-employer plan |
2022-02-01 | Plan is a collectively bargained plan | Yes |
2022-02-01 | Plan funding arrangement – Insurance | Yes |
2022-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-02-01 | Plan benefit arrangement – Insurance | Yes |
2022-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: ROCKET BALL, LTD 2021 form 5500 responses |
---|
2021-02-01 | Type of plan entity | Multi-employer plan |
2021-02-01 | Plan is a collectively bargained plan | Yes |
2021-02-01 | Plan funding arrangement – Insurance | Yes |
2021-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-02-01 | Plan benefit arrangement – Insurance | Yes |
2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: ROCKET BALL, LTD 2020 form 5500 responses |
---|
2020-02-01 | Type of plan entity | Multi-employer plan |
2020-02-01 | Plan is a collectively bargained plan | Yes |
2020-02-01 | Plan funding arrangement – Insurance | Yes |
2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-02-01 | Plan benefit arrangement – Insurance | Yes |
2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: ROCKET BALL, LTD 2019 form 5500 responses |
---|
2019-02-01 | Type of plan entity | Multi-employer plan |
2019-02-01 | Plan funding arrangement – Insurance | Yes |
2019-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-02-01 | Plan benefit arrangement – Insurance | Yes |
2019-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: ROCKET BALL, LTD 2018 form 5500 responses |
---|
2018-02-01 | Type of plan entity | Multi-employer plan |
2018-02-01 | Plan funding arrangement – Insurance | Yes |
2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-02-01 | Plan benefit arrangement – Insurance | Yes |
2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: ROCKET BALL, LTD 2017 form 5500 responses |
---|
2017-02-01 | Type of plan entity | Multi-employer plan |
2017-02-01 | Plan funding arrangement – Insurance | Yes |
2017-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-02-01 | Plan benefit arrangement – Insurance | Yes |
2017-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: ROCKET BALL, LTD 2016 form 5500 responses |
---|
2016-02-01 | Type of plan entity | Multi-employer plan |
2016-02-01 | Submission has been amended | No |
2016-02-01 | This submission is the final filing | No |
2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-02-01 | Plan is a collectively bargained plan | No |
2016-02-01 | Plan funding arrangement – Insurance | Yes |
2016-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-02-01 | Plan benefit arrangement – Insurance | Yes |
2016-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: ROCKET BALL, LTD 2015 form 5500 responses |
---|
2015-02-01 | Type of plan entity | Multi-employer plan |
2015-02-01 | Submission has been amended | No |
2015-02-01 | This submission is the final filing | No |
2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-02-01 | Plan is a collectively bargained plan | No |
2015-02-01 | Plan funding arrangement – Insurance | Yes |
2015-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-02-01 | Plan benefit arrangement – Insurance | Yes |
2015-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: ROCKET BALL, LTD 2014 form 5500 responses |
---|
2014-02-01 | Type of plan entity | Multi-employer plan |
2014-02-01 | Submission has been amended | No |
2014-02-01 | This submission is the final filing | No |
2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-02-01 | Plan is a collectively bargained plan | No |
2014-02-01 | Plan funding arrangement – Insurance | Yes |
2014-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-02-01 | Plan benefit arrangement – Insurance | Yes |
2014-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: ROCKET BALL, LTD 2013 form 5500 responses |
---|
2013-02-01 | Type of plan entity | Multi-employer plan |
2013-02-01 | Submission has been amended | No |
2013-02-01 | This submission is the final filing | No |
2013-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-02-01 | Plan is a collectively bargained plan | No |
2013-02-01 | Plan funding arrangement – Insurance | Yes |
2013-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-02-01 | Plan benefit arrangement – Insurance | Yes |
2013-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: ROCKET BALL, LTD 2012 form 5500 responses |
---|
2012-02-01 | Type of plan entity | Multi-employer plan |
2012-02-01 | Submission has been amended | No |
2012-02-01 | This submission is the final filing | No |
2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-02-01 | Plan is a collectively bargained plan | No |
2012-02-01 | Plan funding arrangement – Insurance | Yes |
2012-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-02-01 | Plan benefit arrangement – Insurance | Yes |
2012-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: ROCKET BALL, LTD 2011 form 5500 responses |
---|
2011-02-01 | Type of plan entity | Multi-employer plan |
2011-02-01 | Submission has been amended | No |
2011-02-01 | This submission is the final filing | No |
2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-02-01 | Plan is a collectively bargained plan | No |
2011-02-01 | Plan funding arrangement – Insurance | Yes |
2011-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-02-01 | Plan benefit arrangement – Insurance | Yes |
2011-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: ROCKET BALL, LTD 2010 form 5500 responses |
---|
2010-02-01 | Type of plan entity | Multi-employer plan |
2010-02-01 | Submission has been amended | No |
2010-02-01 | This submission is the final filing | No |
2010-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-02-01 | Plan is a collectively bargained plan | No |
2010-02-01 | Plan funding arrangement – Insurance | Yes |
2010-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-02-01 | Plan benefit arrangement – Insurance | Yes |
2010-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: ROCKET BALL, LTD 2009 form 5500 responses |
---|
2009-02-01 | Type of plan entity | Multi-employer plan |
2009-02-01 | Submission has been amended | No |
2009-02-01 | This submission is the final filing | No |
2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-02-01 | Plan is a collectively bargained plan | No |
2009-02-01 | Plan funding arrangement – Insurance | Yes |
2009-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-02-01 | Plan benefit arrangement – Insurance | Yes |
2009-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2008: ROCKET BALL, LTD 2008 form 5500 responses |
---|
2008-02-01 | Type of plan entity | Multi-employer plan |
2008-02-01 | First time form 5500 has been submitted | Yes |
2008-02-01 | Submission has been amended | No |
2008-02-01 | This submission is the final filing | No |
2008-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-02-01 | Plan is a collectively bargained plan | No |
2008-02-01 | Plan funding arrangement – Insurance | Yes |
2008-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2008-02-01 | Plan benefit arrangement – Insurance | Yes |
2008-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BBCG |
Policy instance | 2 |
Insurance contract or identification number | GLUG0BBCG | Number of Individuals Covered | 219 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $5,677 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $66,687 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 5677 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 912643 |
Policy instance | 1 |
Insurance contract or identification number | 912643 | Number of Individuals Covered | 401 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,644,904 | 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 number | GLUG0BBCG |
Policy instance | 2 |
Insurance contract or identification number | GLUG0BBCG | Number of Individuals Covered | 183 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $4,917 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $64,375 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 4917 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 912643 |
Policy instance | 1 |
Insurance contract or identification number | 912643 | Number of Individuals Covered | 387 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,725,573 | 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 number | GLUG0BBCG |
Policy instance | 2 |
Insurance contract or identification number | GLUG0BBCG | Number of Individuals Covered | 187 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $5,042 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $72,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 5042 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 912643 |
Policy instance | 1 |
Insurance contract or identification number | 912643 | Number of Individuals Covered | 501 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,421,162 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 912643 |
Policy instance | 1 |
Insurance contract or identification number | 912643 | Number of Individuals Covered | 381 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,654 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,665,014 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 3654 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 547959 |
Policy instance | 2 |
Insurance contract or identification number | 547959 | Number of Individuals Covered | 187 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $5,625 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $139,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 5625 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BBCG |
Policy instance | 3 |
Insurance contract or identification number | GLUG0BBCG | Number of Individuals Covered | 195 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,090 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $71,288 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 3090 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BBCG |
Policy instance | 3 |
Insurance contract or identification number | GLUG0BBCG | Number of Individuals Covered | 217 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $76,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 547959 |
Policy instance | 2 |
Insurance contract or identification number | 547959 | Number of Individuals Covered | 202 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $121,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 912643 |
Policy instance | 1 |
Insurance contract or identification number | 912643 | Number of Individuals Covered | 401 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,268,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466098 |
Policy instance | 2 |
Insurance contract or identification number | 5466098 | Number of Individuals Covered | 201 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $4,140 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CANCER | Welfare Benefit Premiums Paid to Carrier | USD $206,815 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,140 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | USI SOUTHWEST, INC. |
|
MEMORIAL HERMANN HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16433 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 358 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,210,136 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466098 |
Policy instance | 2 |
Insurance contract or identification number | 5466098 | Number of Individuals Covered | 218 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $5,456 | Total amount of fees paid to insurance company | USD $8,780 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT ACCIDENT, CANCER | 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 Carrier | USD $201,640 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,456 | Amount paid for insurance broker fees | 8780 | Additional information about fees paid to insurance broker | FEES AND OTHER COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
|
MEMORIAL HERMANN HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16433 ) |
Policy contract number | L0000026 |
Policy instance | 1 |
Insurance contract or identification number | L0000026 | Number of Individuals Covered | 369 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,158,021 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MEMORIAL HERMANN HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16433 ) |
Policy contract number | L0000026 |
Policy instance | 1 |
Insurance contract or identification number | L0000026 | Number of Individuals Covered | 364 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,087,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466098 |
Policy instance | 2 |
Insurance contract or identification number | 5466098 | Number of Individuals Covered | 210 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $4,235 | Total amount of fees paid to insurance company | USD $5,237 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT ACCIDENT, CANCER | 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 Carrier | USD $173,704 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,235 | Amount paid for insurance broker fees | 5237 | Additional information about fees paid to insurance broker | FEES AND OTHER COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 357 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,305,584 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5466098 |
Policy instance | 2 |
Insurance contract or identification number | 5466098 | Number of Individuals Covered | 205 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $4,895 | Total amount of fees paid to insurance company | USD $1,680 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT ACCIDENT, CANCER | 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 Carrier | USD $55,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,895 | Amount paid for insurance broker fees | 1680 | Additional information about fees paid to insurance broker | FEES AND OTHER COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | ANCO INSURANCE SERVICES CORPORATION |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10040571 |
Policy instance | 2 |
Insurance contract or identification number | 10040571 | Number of Individuals Covered | 197 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $1,328 | Total amount of fees paid to insurance company | USD $910 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 Carrier | USD $26,813 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,328 | Amount paid for insurance broker fees | 910 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 343 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $12,230 | Total amount of fees paid to insurance company | USD $6,430 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,308,026 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,230 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 6430 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | USI INSURANCE SERVICES, LLC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10040571 |
Policy instance | 2 |
Insurance contract or identification number | 10040571 | Number of Individuals Covered | 185 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $1,294 | Total amount of fees paid to insurance company | USD $664 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 Carrier | USD $25,587 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,294 | Amount paid for insurance broker fees | 664 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 343 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $91,352 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,522,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $91,352 | Insurance broker organization code? | 3 | Insurance broker name | ANCO INSURANCE SERVICES CORPORATION |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 343 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $55,296 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,455,040 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $55,296 | Insurance broker organization code? | 3 | Insurance broker name | ANCO INSURANCE SERVICES CORPORATION |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10040571 |
Policy instance | 2 |
Insurance contract or identification number | 10040571 | Number of Individuals Covered | 207 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1,322 | Total amount of fees paid to insurance company | USD $653 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 Carrier | USD $25,972 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,322 | Amount paid for insurance broker fees | 653 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 358 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $70,863 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,542,163 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $70,863 | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10040571 |
Policy instance | 2 |
Insurance contract or identification number | 10040571 | Number of Individuals Covered | 208 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $1,473 | Total amount of fees paid to insurance company | USD $519 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISEMEMBERMENT | 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 Carrier | USD $17,046 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,473 | Amount paid for insurance broker fees | 519 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40N00100000013 |
Policy instance | 3 |
Insurance contract or identification number | 40N00100000013 | Number of Individuals Covered | 52 | Insurance policy start date | 2009-03-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $278 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 Carrier | USD $9,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 278 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 705282 |
Policy instance | 1 |
Insurance contract or identification number | 705282 | Number of Individuals Covered | 375 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $66,473 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,220,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66,473 | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10040571 |
Policy instance | 2 |
Insurance contract or identification number | 10040571 | Number of Individuals Covered | 199 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $1,253 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 Carrier | USD $10,536 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $1,253 | Insurance broker organization code? | 3 | Insurance broker name | ANCO INSURANCE SERVICES CORPORATION |
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