LA BONITA GROCERY & MEAT MARKET INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LA BONITA GROCERY AND MEAT MARKET INC
| Measure | Date | Value |
|---|
| 2022: LA BONITA GROCERY AND MEAT MARKET INC 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 327 |
| Total of all active and inactive participants | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 0 |
| 2021: LA BONITA GROCERY AND MEAT MARKET INC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 408 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 327 |
| Total of all active and inactive participants | 2021-01-01 | 327 |
| Total participants | 2021-01-01 | 327 |
| 2020: LA BONITA GROCERY AND MEAT MARKET INC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 392 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 408 |
| Total of all active and inactive participants | 2020-01-01 | 408 |
| Total participants | 2020-01-01 | 408 |
| 2019: LA BONITA GROCERY AND MEAT MARKET INC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 392 |
| Total of all active and inactive participants | 2019-01-01 | 392 |
| Total participants | 2019-01-01 | 392 |
| 2018: LA BONITA GROCERY AND MEAT MARKET INC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 422 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 444 |
| Total of all active and inactive participants | 2018-01-01 | 444 |
| Total participants | 2018-01-01 | 444 |
| 2017: LA BONITA GROCERY AND MEAT MARKET INC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 402 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 422 |
| Total of all active and inactive participants | 2017-07-01 | 422 |
| Total participants | 2017-07-01 | 422 |
| 2016: LA BONITA GROCERY AND MEAT MARKET INC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 388 |
| Total of all active and inactive participants | 2016-07-01 | 0 |
| Total participants | 2016-07-01 | 0 |
| 2015: LA BONITA GROCERY AND MEAT MARKET INC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 330 |
| Total of all active and inactive participants | 2015-07-01 | 0 |
| Total participants | 2015-07-01 | 0 |
| 2014: LA BONITA GROCERY AND MEAT MARKET INC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 389 |
| Total of all active and inactive participants | 2014-07-01 | 0 |
| Total participants | 2014-07-01 | 0 |
| 2013: LA BONITA GROCERY AND MEAT MARKET INC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 389 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 389 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 389 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-07-01 | 0 |
| Total participants | 2013-07-01 | 389 |
| Number of participants with account balances | 2013-07-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-07-01 | 0 |
| 2012: LA BONITA GROCERY AND MEAT MARKET INC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 282 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 282 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 282 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-07-01 | 0 |
| Total participants | 2012-07-01 | 282 |
| Number of participants with account balances | 2012-07-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-07-01 | 0 |
| Number of employers contributing to the scheme | 2012-07-01 | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,248 | | Total amount of fees paid to insurance company | USD $151 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Commission paid to Insurance Broker | USD $43 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 149 | | Additional information about fees paid to insurance broker | BONUS |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916869 |
| Policy instance | 2 |
| Insurance contract or identification number | 0916869 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $12,026 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $12,026 | | Insurance broker organization code? | 3 |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $48,479 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $48,479 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,772 | | Total amount of fees paid to insurance company | USD $199 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Commission paid to Insurance Broker | USD $47 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 45 | | Additional information about fees paid to insurance broker | BONUS |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916869 |
| Policy instance | 2 |
| Insurance contract or identification number | 0916869 | | Number of Individuals Covered | 411 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $15,098 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $15,098 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 327 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $51,044 | | Health Insurance Welfare Benefit | Yes | | Commission paid to Insurance Broker | USD $51,044 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916869 |
| Policy instance | 2 |
| Insurance contract or identification number | 0916869 | | Number of Individuals Covered | 522 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $15,192 | | Dental Insurance Welfare Benefit | Yes | | 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 $15,192 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $10,864 | | Total amount of fees paid to insurance company | USD $1,737 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $276 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1509 | | Additional information about fees paid to insurance broker | BONUS |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 408 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $55,494 | | Health 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 $55,494 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0916869 |
| Policy instance | 2 |
| Insurance contract or identification number | 0916869 | | Number of Individuals Covered | 497 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $15,820 | | Total amount of fees paid to insurance company | USD $9,646 | | Dental Insurance Welfare Benefit | Yes | | 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 $8,894 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 9646 | | Additional information about fees paid to insurance broker | BONUS |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 392 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $28,961 | | Total amount of fees paid to insurance company | USD $7,240 | | Health 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 $28,961 | | Amount paid for insurance broker fees | 7240 | | Additional information about fees paid to insurance broker | OVERIDE COMPENSATION | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 81 | | Total amount of commissions paid to insurance broker | USD $10,962 | | Total amount of fees paid to insurance company | USD $1,294 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $343 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1229 | | Additional information about fees paid to insurance broker | BONUS |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $48,812 | | Health 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 $48,812 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $4,648 | | Total amount of fees paid to insurance company | USD $258 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $196 | | Amount paid for insurance broker fees | 33 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 10006683 |
| Policy instance | 2 |
| Insurance contract or identification number | 10006683 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $13,489 | | Dental Insurance Welfare Benefit | Yes | | 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 $13,489 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 3 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,804 | | Total amount of fees paid to insurance company | USD $377 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | 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 | | Amount paid for insurance broker fees | 42 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS (National Association of Insurance Commissioners NAIC id number: 71773 ) |
| Policy contract number | 10006683 |
| Policy instance | 2 |
| Insurance contract or identification number | 10006683 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $4,812 | | Dental Insurance Welfare Benefit | Yes | | 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 $4,812 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $26,645 | | Health 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 $26,645 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 4 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $7,120 | | Total amount of fees paid to insurance company | USD $6,139 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $25,907 | | Commission paid to Insurance Broker | USD $2,490 | | Amount paid for insurance broker fees | 4889 | | Additional information about fees paid to insurance broker | CONSULTING FEES | | Insurance broker organization code? | 3 | | Insurance broker name | OMNI INSURANCE BROKERAGE INC |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 426 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $13,800 | | Total amount of fees paid to insurance company | USD $62,320 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,010,539 | | Commission paid to Insurance Broker | USD $13,800 | | Amount paid for insurance broker fees | 62320 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | DOROSHOW INSURANCE |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00478347 |
| Policy instance | 2 |
| Insurance contract or identification number | 00478347 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $2,013 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,253 | | Commission paid to Insurance Broker | USD $1,018 | | Insurance broker organization code? | 3 | | Insurance broker name | ELEVATE INSURANCE LLC |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9850637 |
| Policy instance | 3 |
| Insurance contract or identification number | 9850637 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $577 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,566 | | Commission paid to Insurance Broker | USD $577 | | Insurance broker organization code? | 3 | | Insurance broker name | ELEVATE INSURANCE LLC |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9850637 |
| Policy instance | 3 |
| Insurance contract or identification number | 9850637 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $432 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,168 | | Commission paid to Insurance Broker | USD $432 | | Insurance broker organization code? | 3 | | Insurance broker name | DOROSHOW INSURANCE |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00478347 |
| Policy instance | 2 |
| Insurance contract or identification number | 00478347 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,293 | | Total amount of fees paid to insurance company | USD $902 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,953 | | Commission paid to Insurance Broker | USD $2,248 | | Amount paid for insurance broker fees | 902 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | V W ALLABASHI & ASSOCIATERS, LLC |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 389 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $43,690 | | Total amount of fees paid to insurance company | USD $2,029 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $743,550 | | Commission paid to Insurance Broker | USD $43,690 | | Amount paid for insurance broker fees | 2029 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | DOROSHOW INSURANCE |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 4 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $3,916 | | Total amount of fees paid to insurance company | USD $2,463 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $18,604 | | Commission paid to Insurance Broker | USD $1,048 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2073 | | Additional information about fees paid to insurance broker | CONSULTING FEES | | Insurance broker name | HOLLERN AND ASSOCIATES |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7840051 |
| Policy instance | 4 |
| Insurance contract or identification number | E7840051 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,930 | | Total amount of fees paid to insurance company | USD $289 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $13,502 | | Commission paid to Insurance Broker | USD $827 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 144 | | Additional information about fees paid to insurance broker | CONSULTING FEES | | Insurance broker name | JESSE J RENTERIA JR |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9850637 |
| Policy instance | 3 |
| Insurance contract or identification number | 9850637 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $350 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,817 | | Commission paid to Insurance Broker | USD $350 | | Insurance broker organization code? | 3 | | Insurance broker name | DOROSHOW INSURANCE |
|
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500512 |
| Policy instance | 1 |
| Insurance contract or identification number | 50500512 | | Number of Individuals Covered | 282 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $34,620 | | Total amount of fees paid to insurance company | USD $4,835 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $585,716 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,620 | | Amount paid for insurance broker fees | 4835 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | DOROSHOW INSURANCE |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00478347 |
| Policy instance | 2 |
| Insurance contract or identification number | 00478347 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $2,584 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,181 | | Commission paid to Insurance Broker | USD $2,404 | | Insurance broker organization code? | 3 | | Insurance broker name | V.W. ALLABASHI AND ASSOCIATES, LLC |
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