SUNDANCE PARTNERS LTD has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SUNDANCE PARTNERS EMPLOYEE BENEFITS
| Measure | Date | Value |
|---|
| 2020: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 157 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 157 |
| Number of employers contributing to the scheme | 2020-01-01 | 2 |
| 2019: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 177 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 177 |
| Number of employers contributing to the scheme | 2019-01-01 | 2 |
| 2018: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 169 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 169 |
| Number of employers contributing to the scheme | 2018-01-01 | 2 |
| 2017: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 101 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 101 |
| Number of employers contributing to the scheme | 2017-01-01 | 2 |
| 2015: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 89 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 94 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| 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 | 94 |
| 2014: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 91 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| 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 | 91 |
| 2013: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 101 |
| Total of all active and inactive participants | 2013-01-01 | 101 |
| Total participants | 2013-01-01 | 101 |
| 2012: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 101 |
| Total of all active and inactive participants | 2012-01-01 | 101 |
| Total participants | 2012-01-01 | 101 |
| 2011: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 104 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 104 |
| Total participants | 2011-01-01 | 104 |
| 2010: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 111 |
| Total of all active and inactive participants | 2010-01-01 | 111 |
| Total participants | 2010-01-01 | 111 |
| 2009: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 285 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 95 |
| Total of all active and inactive participants | 2009-01-01 | 95 |
| Total participants | 2009-01-01 | 95 |
| 2020: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Multi-employer plan |
| 2020-01-01 | Submission has been amended | Yes |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan is a collectively bargained plan | Yes |
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Multi-employer plan |
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Multi-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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Multi-employer plan |
| 2017-01-01 | Submission has been amended | Yes |
| 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 |
| 2015: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2015 form 5500 responses |
|---|
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2014 form 5500 responses |
|---|
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2013 form 5500 responses |
|---|
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 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: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | Yes |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SUNDANCE PARTNERS EMPLOYEE BENEFITS 2009 form 5500 responses |
|---|
| 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 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 306493 |
| Policy instance | 5 |
| Insurance contract or identification number | 306493 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 4 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $2,471 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,471 | | Insurance broker organization code? | 3 |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | FQS UTZ29385 |
| Policy instance | 3 |
| Insurance contract or identification number | FQS UTZ29385 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $1,876 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,876 | | Insurance broker organization code? | 3 |
|
| OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 ) |
| Policy contract number | FQS 8UTVI29385 |
| Policy instance | 2 |
| Insurance contract or identification number | FQS 8UTVI29385 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,875 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,875 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 908985 |
| Policy instance | 1 |
| Insurance contract or identification number | 908985 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $64,321 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,237,618 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,321 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 908985 |
| Policy instance | 1 |
| Insurance contract or identification number | 908985 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $62,486 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,193,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,486 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 ) |
| Policy contract number | FQS 8UTVI29385 |
| Policy instance | 2 |
| Insurance contract or identification number | FQS 8UTVI29385 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $229 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $229 | | Insurance broker organization code? | 3 |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | FQS UTZ29385 |
| Policy instance | 3 |
| Insurance contract or identification number | FQS UTZ29385 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,863 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,863 | | Insurance broker organization code? | 3 |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 4 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $2,314 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,571 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,314 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 306493 |
| Policy instance | 5 |
| Insurance contract or identification number | 306493 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $877 | | Welfare Benefit Premiums Paid to Carrier | USD $9,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $877 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 908985 |
| Policy instance | 1 |
| Insurance contract or identification number | 908985 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $63,996 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,124,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,996 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 ) |
| Policy contract number | FQS 8UTVI29385 |
| Policy instance | 2 |
| Insurance contract or identification number | FQS 8UTVI29385 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $228 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $228 | | Insurance broker organization code? | 3 |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | FQS UTZ29385 |
| Policy instance | 3 |
| Insurance contract or identification number | FQS UTZ29385 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 4 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $2,385 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,752 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,385 | | Insurance broker organization code? | 3 |
|
| INTERMOUNTAIN EAP (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 222 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INTERMOUNTAIN EAP (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 547 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 4 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $3,092 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,092 | | Insurance broker organization code? | 3 | | Insurance broker name | NFP CORP SERVICES |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | FQS UTZ29385 |
| Policy instance | 3 |
| Insurance contract or identification number | FQS UTZ29385 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $1,750 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,720 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,750 | | Insurance broker organization code? | 3 | | Insurance broker name | NFP CORP SERVICES |
|
| OPTICARE OF UTAH (National Association of Insurance Commissioners NAIC id number: 12533 ) |
| Policy contract number | FQS 8UTVI29385 |
| Policy instance | 2 |
| Insurance contract or identification number | FQS 8UTVI29385 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $254 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,581 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $254 | | Insurance broker organization code? | 3 | | Insurance broker name | NFP CORP SERVICES |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 908985 |
| Policy instance | 1 |
| Insurance contract or identification number | 908985 | | Number of Individuals Covered | 251 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of fees paid to insurance company | USD $57,201 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,180,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 57201 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 | | Insurance broker name | NFP COORPORATE SERVICES (UT) INC |
|
| INTERMOUNTAIN EAP (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 489 |
| Policy instance | 1 |
| Insurance contract or identification number | 489 | | Number of Individuals Covered | 468 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| INTERMOUNTAIN EAP (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 489 |
| Policy instance | 1 |
| Insurance contract or identification number | 489 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,500 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 1 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $2,857 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417002410751 |
| Policy instance | 2 |
| Insurance contract or identification number | 417002410751 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $12,147 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $121,254 |
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| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417002410751 |
| Policy instance | 1 |
| Insurance contract or identification number | 417002410751 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $12,147 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $121,254 | | Commission paid to Insurance Broker | USD $12,147 | | Insurance broker organization code? | 3 | | Insurance broker name | FIRSTWEST BENEFIT SOLUTIONS |
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| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 2 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-08-31 | | Total amount of commissions paid to insurance broker | USD $2,857 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Commission paid to Insurance Broker | USD $2,857 | | Insurance broker organization code? | 3 | | Insurance broker name | KIRK BENSON FIRST WEST BENEFIT SOL |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417002410751 |
| Policy instance | 2 |
| Insurance contract or identification number | 417002410751 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $13,461 | | Welfare Benefit Premiums Paid to Carrier | USD $134,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,461 | | Additional information about fees paid to insurance broker | MANAGING PRODUCER FEE | | Insurance broker organization code? | 3 | | Insurance broker name | FIRSTWEST BENEFIT SOLUTIONS |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 1 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-08-31 | | Total amount of commissions paid to insurance broker | USD $2,710 | | 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 $2,710 | | Insurance broker organization code? | 3 | | Insurance broker name | KIRK BENSON FIRSTWEST |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417002410751 |
| Policy instance | 1 |
| Insurance contract or identification number | 417002410751 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $13,103 | | Welfare Benefit Premiums Paid to Carrier | USD $130,831 |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 2 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2011-08-31 | | Total amount of commissions paid to insurance broker | USD $2,917 | | Dental Insurance Welfare Benefit | Yes |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL128384 |
| Policy instance | 2 |
| Insurance contract or identification number | GL128384 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $494 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D, DEPENDENT LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $4,120 | | Commission paid to Insurance Broker | USD $494 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT HESS & COMPANY |
|
| SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
| Policy contract number | G1006739 |
| Policy instance | 3 |
| Insurance contract or identification number | G1006739 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $10,375 | | Total amount of fees paid to insurance company | USD $4,042 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $477,104 | | Commission paid to Insurance Broker | USD $10,375 | | Amount paid for insurance broker fees | 4042 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | FIRST WEST BENEFIT SOLUTIONS |
|
| EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 12515 ) |
| Policy contract number | 2075 |
| Policy instance | 4 |
| Insurance contract or identification number | 2075 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2009-09-01 | | Insurance policy end date | 2010-08-31 | | Total amount of commissions paid to insurance broker | USD $3,035 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Commission paid to Insurance Broker | USD $3,035 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | STEVE MURDOCK / FIRST WEST |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | 417002410751 |
| Policy instance | 5 |
| Insurance contract or identification number | 417002410751 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,556 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $45,591 | | Commission paid to Insurance Broker | USD $4,556 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | FIRSTWEST BENEFIT SOLUTIONS |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G152657 |
| Policy instance | 6 |
| Insurance contract or identification number | G152657 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,009 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,727 | | Commission paid to Insurance Broker | USD $1,009 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT HESS & COMPANY |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3169620 |
| Policy instance | 7 |
| Insurance contract or identification number | E3169620 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $460 | | Total amount of fees paid to insurance company | USD $17 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,181 | | Commission paid to Insurance Broker | USD $303 | | Amount paid for insurance broker fees | 11 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | TIM VINCENT |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 104008 |
| Policy instance | 1 |
| Insurance contract or identification number | LTD 104008 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $800 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $800 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER SERVICES | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT HESS & COMPANY |
|
