STYX ACQUISITION LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2023: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-04-01 | 754 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-04-01 | 727 |
| Number of retired or separated participants receiving benefits | 2023-04-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2023-04-01 | 16 |
| Total of all active and inactive participants | 2023-04-01 | 745 |
| Number of employers contributing to the scheme | 2023-04-01 | 0 |
| 2022: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-04-01 | 759 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 758 |
| Number of retired or separated participants receiving benefits | 2022-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-04-01 | 24 |
| Total of all active and inactive participants | 2022-04-01 | 783 |
| Number of employers contributing to the scheme | 2022-04-01 | 0 |
| 2021: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-04-01 | 703 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 698 |
| Number of retired or separated participants receiving benefits | 2021-04-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2021-04-01 | 22 |
| Total of all active and inactive participants | 2021-04-01 | 727 |
| Number of employers contributing to the scheme | 2021-04-01 | 0 |
| 2020: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 666 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 694 |
| Number of retired or separated participants receiving benefits | 2020-04-01 | 10 |
| Number of other retired or separated participants entitled to future benefits | 2020-04-01 | 27 |
| Total of all active and inactive participants | 2020-04-01 | 731 |
| Number of employers contributing to the scheme | 2020-04-01 | 0 |
| 2019: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 673 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 654 |
| Number of retired or separated participants receiving benefits | 2019-04-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2019-04-01 | 14 |
| Total of all active and inactive participants | 2019-04-01 | 675 |
| Number of employers contributing to the scheme | 2019-04-01 | 0 |
| 2018: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 638 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 674 |
| Total of all active and inactive participants | 2018-04-01 | 674 |
| 2017: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-08-28 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-08-28 | 638 |
| Total of all active and inactive participants | 2017-08-28 | 638 |
| 2023: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2023 form 5500 responses |
|---|
| 2023-04-01 | Type of plan entity | Single employer plan |
| 2023-04-01 | Plan funding arrangement – Insurance | Yes |
| 2023-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: STYX ACQUISITION LLC EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-08-28 | Type of plan entity | Single employer plan |
| 2017-08-28 | First time form 5500 has been submitted | Yes |
| 2017-08-28 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-08-28 | Plan funding arrangement – Insurance | Yes |
| 2017-08-28 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-08-28 | Plan benefit arrangement – Insurance | Yes |
| 2017-08-28 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 10274504 |
| Policy instance | 3 |
| Insurance contract or identification number | 10274504 | | Number of Individuals Covered | 648 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $13,939 | | 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 $188,878 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 ) |
| Policy contract number | 10751 |
| Policy instance | 2 |
| Insurance contract or identification number | 10751 | | Number of Individuals Covered | 546 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $14,512 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 4774 |
| Policy instance | 1 |
| Insurance contract or identification number | 4774 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2023-04-01 | | Insurance policy end date | 2024-03-31 | | Total amount of commissions paid to insurance broker | USD $2,646 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 4774 |
| Policy instance | 1 |
| Insurance contract or identification number | 4774 | | Number of Individuals Covered | 320 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $2,297 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,297 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 735384 |
| Policy instance | 2 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 371 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $14,842 | | Total amount of fees paid to insurance company | USD $5,710 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,842 | | Amount paid for insurance broker fees | 5710 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| CONSUMERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62375 ) |
| Policy contract number | 735384 |
| Policy instance | 3 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 707 | | Insurance policy start date | 2022-04-01 | | Insurance policy end date | 2023-03-31 | | Total amount of commissions paid to insurance broker | USD $15,338 | | Total amount of fees paid to insurance company | USD $13,117 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $288,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,338 | | Amount paid for insurance broker fees | 13117 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| CONSUMERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62375 ) |
| Policy contract number | 735384 |
| Policy instance | 3 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 660 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $19,777 | | Total amount of fees paid to insurance company | USD $13,318 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $288,778 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,777 | | Amount paid for insurance broker fees | 13318 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 735384 |
| Policy instance | 2 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 368 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $15,383 | | Total amount of fees paid to insurance company | USD $4,363 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,383 | | Amount paid for insurance broker fees | 4363 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 4774 |
| Policy instance | 1 |
| Insurance contract or identification number | 4774 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2022-03-31 | | Total amount of commissions paid to insurance broker | USD $2,364 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,364 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| CONSUMERS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62375 ) |
| Policy contract number | 735384 |
| Policy instance | 3 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 659 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $14,369 | | Total amount of fees paid to insurance company | USD $13,163 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $280,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,369 | | Amount paid for insurance broker fees | 12549 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 ) |
| Policy contract number | 735384 |
| Policy instance | 2 |
| Insurance contract or identification number | 735384 | | Number of Individuals Covered | 373 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $14,579 | | Total amount of fees paid to insurance company | USD $1,152 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,579 | | Amount paid for insurance broker fees | 1152 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
| Policy contract number | 4774 |
| Policy instance | 1 |
| Insurance contract or identification number | 4774 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2021-03-31 | | Total amount of commissions paid to insurance broker | USD $2,535 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,535 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | BFFI1117 |
| Policy instance | 1 |
| Insurance contract or identification number | BFFI1117 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $15,336 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $153,359 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,336 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0AHYM |
| Policy instance | 2 |
| Insurance contract or identification number | GLUG0AHYM | | Number of Individuals Covered | 654 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $37,868 | | Total amount of fees paid to insurance company | USD $37,516 | | 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 $230,028 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,868 | | Amount paid for insurance broker fees | 34574 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | BFFI1117 |
| Policy instance | 1 |
| Insurance contract or identification number | BFFI1117 | | Number of Individuals Covered | 350 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $19,287 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $192,874 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,287 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHYM |
| Policy instance | 2 |
| Insurance contract or identification number | G000AHYM | | Number of Individuals Covered | 674 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $20,248 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $136,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 16413 | | 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 | G000AHYM |
| Policy instance | 3 |
| Insurance contract or identification number | G000AHYM | | Number of Individuals Covered | 212 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $13,623 | | Total amount of fees paid to insurance company | USD $12,232 | | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $90,816 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,077 | | Amount paid for insurance broker fees | 9845 | | 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 | G000AHYM |
| Policy instance | 3 |
| Insurance contract or identification number | G000AHYM | | Number of Individuals Covered | 237 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $5,316 | | Total amount of fees paid to insurance company | USD $5,794 | | Other welfare benefits provided | VOLUNTARY LIFE & AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $35,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,316 | | Amount paid for insurance broker fees | 4778 | | Additional information about fees paid to insurance broker | OTHER COMPENSATOIN | | Insurance broker organization code? | 3 | | Insurance broker name | NFP INSURANCE SERVICES INC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AHYM |
| Policy instance | 2 |
| Insurance contract or identification number | G000AHYM | | Number of Individuals Covered | 638 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $22,164 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $53,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 13260 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP INSURANCE SERVICES INC |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | BFFI1117 |
| Policy instance | 1 |
| Insurance contract or identification number | BFFI1117 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $7,295 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,295 | | Insurance broker organization code? | 3 | | Insurance broker name | CHAPMAN & CHAPMAN, INC. |
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