COMPLETE RX, LTD. has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2022: COMPLETERX MEDICAL PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 101 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 95 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 3 |
Total of all active and inactive participants | 2022-01-01 | 101 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: COMPLETERX MEDICAL PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 211 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 97 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 5 |
Total of all active and inactive participants | 2021-01-01 | 105 |
Number of employers contributing to the scheme | 2021-01-01 | 0 |
2020: COMPLETERX MEDICAL PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 207 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 207 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 6 |
Total of all active and inactive participants | 2020-01-01 | 217 |
Number of employers contributing to the scheme | 2020-01-01 | 0 |
2019: COMPLETERX MEDICAL PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 188 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 200 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 5 |
Total of all active and inactive participants | 2019-01-01 | 207 |
Number of employers contributing to the scheme | 2019-01-01 | 0 |
2018: COMPLETERX MEDICAL PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 211 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 202 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 8 |
Total of all active and inactive participants | 2018-01-01 | 214 |
Number of employers contributing to the scheme | 2018-01-01 | 0 |
2017: COMPLETERX MEDICAL PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 206 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 212 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 4 |
Total of all active and inactive participants | 2017-01-01 | 220 |
2016: COMPLETERX MEDICAL PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 175 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 206 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 1 |
Total of all active and inactive participants | 2016-01-01 | 208 |
2015: COMPLETERX MEDICAL PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 157 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 174 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 175 |
2014: COMPLETERX MEDICAL PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 180 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 182 |
2013: COMPLETERX MEDICAL PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 223 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 162 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 166 |
2012: COMPLETERX MEDICAL PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 345 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 295 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 295 |
2011: COMPLETERX MEDICAL PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 345 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 345 |
2009: COMPLETERX MEDICAL PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 266 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 298 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 305 |
2022: COMPLETERX MEDICAL PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: COMPLETERX MEDICAL PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: COMPLETERX MEDICAL PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: COMPLETERX MEDICAL PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | Yes |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: COMPLETERX MEDICAL PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: COMPLETERX MEDICAL PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: COMPLETERX MEDICAL PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: COMPLETERX MEDICAL PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: COMPLETERX MEDICAL PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: COMPLETERX MEDICAL PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: COMPLETERX MEDICAL PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: COMPLETERX MEDICAL PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: COMPLETERX MEDICAL PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 3 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 152 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $74,204 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 2 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 63 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,434 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 96 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $2,146 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $82,679 | 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 | 2146 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 62 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,173 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $118,011 | 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 | 3173 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 2 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 68 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,218 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 3 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 149 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $104,136 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 3 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 123 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,565 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 2 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 254 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $132,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 226 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,061 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $149,868 | 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 | 3061 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 4 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 121 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 3 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 247 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $117,261 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 110781 |
Policy instance | 2 |
Insurance contract or identification number | 110781 | Number of Individuals Covered | 224 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LEGAL | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,892 | Commission paid to Insurance Broker | USD $416 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 224 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $2,748 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $132,262 | 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 | 2748 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 204 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $2,817 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $133,575 | 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 | 2817 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 110781 |
Policy instance | 2 |
Insurance contract or identification number | 110781 | Number of Individuals Covered | 22 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $374 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $2,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $268 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 |
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DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 3 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 256 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $127,561 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 4 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 112 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,680 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12268654 |
Policy instance | 4 |
Insurance contract or identification number | 12268654 | Number of Individuals Covered | 119 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 17472 |
Policy instance | 3 |
Insurance contract or identification number | 17472 | Number of Individuals Covered | 272 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $121,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 110781 |
Policy instance | 2 |
Insurance contract or identification number | 110781 | Number of Individuals Covered | 26 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,004 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $3,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $814 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 | Insurance broker name | WILLIAM STIFFLER |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 238437 |
Policy instance | 1 |
Insurance contract or identification number | 238437 | Number of Individuals Covered | 212 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,820 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $103,019 | 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 | 1820 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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