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ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN
Plan identification number 502

ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:ELM
Employer identification number (EIN):810529580
NAIC Classification:541370
NAIC Description:Surveying and Mapping (except Geophysical) Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01MATT WAUGH
5022017-01-01MATT WAUGH
5022016-01-01MATT WAUGH
5022015-01-01MATT WAUGH
5022014-01-01MATT WAUGH
5022013-01-01MATT WAUGH
5022012-01-01JIM BOURAZAK
5022011-01-01JAMES BOURAZAK
5022010-01-01JAMES BOURAZAK
5022009-01-01LEE C GRAVES

Plan Statistics for ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN

401k plan membership statisitcs for ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN

Measure Date Value
2022: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01779
Total number of active participants reported on line 7a of the Form 55002022-01-01890
Total of all active and inactive participants2022-01-01890
Total participants2022-01-01890
2021: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01722
Total number of active participants reported on line 7a of the Form 55002021-01-01761
Total of all active and inactive participants2021-01-01761
Total participants2021-01-01761
2020: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01716
Total number of active participants reported on line 7a of the Form 55002020-01-01784
Total of all active and inactive participants2020-01-01784
Total participants2020-01-01784
2019: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01595
Total number of active participants reported on line 7a of the Form 55002019-01-01715
Total of all active and inactive participants2019-01-01715
Total participants2019-01-01715
2018: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01596
Total number of active participants reported on line 7a of the Form 55002018-01-01610
Total of all active and inactive participants2018-01-01610
Total participants2018-01-01610
2017: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01525
Total number of active participants reported on line 7a of the Form 55002017-01-01642
Total of all active and inactive participants2017-01-01642
Total participants2017-01-01642
2016: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01572
Total number of active participants reported on line 7a of the Form 55002016-01-01826
Total of all active and inactive participants2016-01-01826
Total participants2016-01-01826
2015: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01488
Total number of active participants reported on line 7a of the Form 55002015-01-01572
Total of all active and inactive participants2015-01-01572
Total participants2015-01-010
2014: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01509
Total number of active participants reported on line 7a of the Form 55002014-01-01318
Total of all active and inactive participants2014-01-01318
Total participants2014-01-010
2013: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01669
Total number of active participants reported on line 7a of the Form 55002013-01-01509
Total of all active and inactive participants2013-01-01509
Total participants2013-01-010
2012: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01532
Total number of active participants reported on line 7a of the Form 55002012-01-01663
Number of retired or separated participants receiving benefits2012-01-016
Total of all active and inactive participants2012-01-01669
2011: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01453
Total number of active participants reported on line 7a of the Form 55002011-01-01524
Number of retired or separated participants receiving benefits2011-01-018
Total of all active and inactive participants2011-01-01532
2010: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01625
Total number of active participants reported on line 7a of the Form 55002010-01-01446
Number of retired or separated participants receiving benefits2010-01-017
Total of all active and inactive participants2010-01-01453
2009: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01753
Total number of active participants reported on line 7a of the Form 55002009-01-01612
Number of retired or separated participants receiving benefits2009-01-0113
Total of all active and inactive participants2009-01-01625

Form 5500 Responses for ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN

2022: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: ONE CALL LOCATORS, LTD. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number923313
Policy instance 1
Insurance contract or identification number923313
Number of Individuals Covered942
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $103,560
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,688,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $103,560
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number923313
Policy instance 1
Insurance contract or identification number923313
Number of Individuals Covered932
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,341
Total amount of fees paid to insurance companyUSD $85,654
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,212,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,341
Amount paid for insurance broker fees77900
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number225271
Policy instance 5
Insurance contract or identification number225271
Number of Individuals Covered572
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $59,677
Total amount of fees paid to insurance companyUSD $9,225
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,441,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,677
Amount paid for insurance broker fees9225
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 4
Insurance contract or identification number164993
Number of Individuals Covered415
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,189
Total amount of fees paid to insurance companyUSD $2,457
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,189
Amount paid for insurance broker fees2457
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 3
Insurance contract or identification number164993
Number of Individuals Covered357
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,497
Total amount of fees paid to insurance companyUSD $525
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,497
Amount paid for insurance broker fees525
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 2
Insurance contract or identification number164993
Number of Individuals Covered114
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,886
Total amount of fees paid to insurance companyUSD $1,360
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,886
Amount paid for insurance broker fees1360
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 1
Insurance contract or identification number164993
Number of Individuals Covered634
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,778
Total amount of fees paid to insurance companyUSD $4,822
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,778
Amount paid for insurance broker fees4822
Additional information about fees paid to insurance brokerADMINSTRATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 1
Insurance contract or identification number164993
Number of Individuals Covered553
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $14,431
Total amount of fees paid to insurance companyUSD $3,603
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,431
Amount paid for insurance broker fees3603
Additional information about fees paid to insurance brokerADMINSTRATION
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 2
Insurance contract or identification number164993
Number of Individuals Covered96
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,001
Total amount of fees paid to insurance companyUSD $1,073
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,001
Amount paid for insurance broker fees1073
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 3
Insurance contract or identification number164993
Number of Individuals Covered307
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,764
Total amount of fees paid to insurance companyUSD $428
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,764
Amount paid for insurance broker fees428
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number164993
Policy instance 4
Insurance contract or identification number164993
Number of Individuals Covered346
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,857
Total amount of fees paid to insurance companyUSD $2,001
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,857
Amount paid for insurance broker fees2001
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?1
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number225271
Policy instance 5
Insurance contract or identification number225271
Number of Individuals Covered507
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $55,996
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,222,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,996
Insurance broker organization code?3
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1514603
Policy instance 3
Insurance contract or identification number1514603
Number of Individuals Covered610
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $11,399
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11399
Additional information about fees paid to insurance brokerADMINISTRATIVE OR OTHER FEES
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number304886
Policy instance 2
Insurance contract or identification number304886
Number of Individuals Covered674
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,594
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,594
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number910254
Policy instance 1
Insurance contract or identification number910254
Number of Individuals Covered539
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,827
Total amount of fees paid to insurance companyUSD $6,023
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,863,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,827
Amount paid for insurance broker fees6023
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT & 2,000 BONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12257726
Policy instance 1
Insurance contract or identification number12257726
Number of Individuals Covered233
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,752
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,752
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number910254
Policy instance 2
Insurance contract or identification number910254
Number of Individuals Covered462
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $63,749
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,294,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees63749
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT & 1,000 BONUS
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number641745
Policy instance 3
Insurance contract or identification number641745
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
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 number304886
Policy instance 5
Insurance contract or identification number304886
Number of Individuals Covered642
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,274
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,274
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1514603
Policy instance 4
Insurance contract or identification number1514603
Number of Individuals Covered427
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $436
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees436
Additional information about fees paid to insurance brokerADMINISTRATIVE OR OTHER FEES
Insurance broker organization code?3
Insurance broker nameOPTUM HEALTH
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD125799
Policy instance 6
Insurance contract or identification numberLTD125799
Number of Individuals Covered11
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $236
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $236
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 153523
Policy instance 3
Insurance contract or identification numberGL 153523
Number of Individuals Covered591
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,202
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,202
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL301706
Policy instance 5
Insurance contract or identification numberVPL301706
Number of Individuals Covered77
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,211
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,211
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12257726
Policy instance 1
Insurance contract or identification number12257726
Number of Individuals Covered201
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,612
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,612
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPS 326664
Policy instance 4
Insurance contract or identification numberVPS 326664
Number of Individuals Covered104
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,242
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,242
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 2
Insurance contract or identification numberP41745
Number of Individuals Covered211
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $25,154
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,124,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,154
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number226890
Policy instance 1
Insurance contract or identification number226890
Number of Individuals Covered169
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,155
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,155
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number225406
Policy instance 2
Insurance contract or identification number225406
Number of Individuals Covered367
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,454
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,454
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12257726
Policy instance 3
Insurance contract or identification number12257726
Number of Individuals Covered151
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,272
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,272
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 4
Insurance contract or identification numberP41745
Number of Individuals Covered160
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $18,331
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $808,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,331
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number225406
Policy instance 2
Insurance contract or identification number225406
Number of Individuals Covered80802
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,566
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,566
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number12257726
Policy instance 3
Insurance contract or identification number12257726
Number of Individuals Covered197
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,672
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,672
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number226890
Policy instance 1
Insurance contract or identification number226890
Number of Individuals Covered243
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $714
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $714
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 4
Insurance contract or identification numberP41745
Number of Individuals Covered154
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $19,980
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $869,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,980
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTING INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 3
Insurance contract or identification numberP41745
Number of Individuals Covered189
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $18,766
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,253,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,766
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTANTS, INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 2
Insurance contract or identification numberP41745
Number of Individuals Covered194
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,965
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $652,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,965
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTANTS, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D0385
Policy instance 1
Insurance contract or identification numberF1D0385
Number of Individuals Covered551
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,714
Total amount of fees paid to insurance companyUSD $96
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL. LIFE, VOL. DEPEND LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $60,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,714
Amount paid for insurance broker fees96
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?3
Insurance broker nameKEPPLE HEALTHCARE CONSULTANTS, INC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 2
Insurance contract or identification numberP41745
Number of Individuals Covered550
Insurance policy start date2010-06-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,659
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,125,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D0385
Policy instance 1
Insurance contract or identification numberF1D0385
Number of Individuals Covered433
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $11,163
Total amount of fees paid to insurance companyUSD $411
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL. LIFE, VOL. DEPEND LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $65,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D0385
Policy instance 1
Insurance contract or identification numberF1D0385
Number of Individuals Covered508
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $7,506
Total amount of fees paid to insurance companyUSD $211
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL. LIFE, VOL. DEPEND LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $48,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number454-3216-00-03
Policy instance 2
Insurance contract or identification number454-3216-00-03
Number of Individuals Covered356
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $3,698
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL. LIFE, VOL. DEPEND LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $31,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract numberP41745
Policy instance 3
Insurance contract or identification numberP41745
Number of Individuals Covered669
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,269,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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