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ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NameELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN
Plan identification number 001

ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ELLIOTT BAY ANIMAL HOSPITAL, INC. P has sponsored the creation of one or more 401k plans.

Company Name:ELLIOTT BAY ANIMAL HOSPITAL, INC. P
Employer identification number (EIN):911110371
NAIC Classification:541940
NAIC Description:Veterinary Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01JOHN C KELLY2021-07-19
0012020-01-01JOHN C KELLY2021-06-22
0012019-01-01JOHN C KELLY2020-04-30
0012018-01-01JOHN C KELLY2019-06-26
0012017-01-01JOHN C KELLY
0012016-01-01JOHN C KELLY
0012015-01-01JOHN C KELLY
0012014-01-01JOHN C KELLY
0012013-01-01JOHN C KELLY
0012012-01-01JOHN C KELLY2013-07-22
0012011-01-01JOHN C KELLY2012-07-11
0012010-01-01JOHN C KELLY2011-07-13

Plan Statistics for ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2017: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0149
Total number of active participants reported on line 7a of the Form 55002017-01-0137
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0117
Total of all active and inactive participants2017-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0154
Number of participants with account balances2017-01-0154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0148
Total number of active participants reported on line 7a of the Form 55002016-01-0134
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0114
Total of all active and inactive participants2016-01-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0148
Number of participants with account balances2016-01-0136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0152
Total number of active participants reported on line 7a of the Form 55002015-01-0131
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0115
Total of all active and inactive participants2015-01-0146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0146
Number of participants with account balances2015-01-0139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0156
Total number of active participants reported on line 7a of the Form 55002014-01-0136
Number of retired or separated participants receiving benefits2014-01-012
Number of other retired or separated participants entitled to future benefits2014-01-0113
Total of all active and inactive participants2014-01-0151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0151
Number of participants with account balances2014-01-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0152
Total number of active participants reported on line 7a of the Form 55002013-01-0134
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0120
Total of all active and inactive participants2013-01-0154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0154
Number of participants with account balances2013-01-0153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Financial Data on ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2017 : ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total income from all sources2017-12-31$551,162
Expenses. Total of all expenses incurred2017-12-31$15,727
Benefits paid (including direct rollovers)2017-12-31$3,252
Total plan assets at end of year2017-12-31$3,123,430
Total plan assets at beginning of year2017-12-31$2,587,995
Value of fidelity bond covering the plan2017-12-31$275,000
Total contributions received or receivable from participants2017-12-31$88,921
Other income received2017-12-31$408,151
Net income (gross income less expenses)2017-12-31$535,435
Net plan assets at end of year (total assets less liabilities)2017-12-31$3,123,430
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$2,587,995
Assets. Value of participant loans2017-12-31$30,631
Total contributions received or receivable from employer(s)2017-12-31$54,090
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$12,475
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2016 401k financial data
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$257,334
Expenses. Total of all expenses incurred2016-12-31$150,171
Benefits paid (including direct rollovers)2016-12-31$117,976
Total plan assets at end of year2016-12-31$2,587,995
Total plan assets at beginning of year2016-12-31$2,480,832
Value of fidelity bond covering the plan2016-12-31$275,000
Total contributions received or receivable from participants2016-12-31$65,113
Other income received2016-12-31$192,221
Net income (gross income less expenses)2016-12-31$107,163
Net plan assets at end of year (total assets less liabilities)2016-12-31$2,587,995
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$2,480,832
Assets. Value of participant loans2016-12-31$4,025
Value of certain deemed distributions of participant loans2016-12-31$3,857
Value of corrective distributions2016-12-31$19,559
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$8,779
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$28,936
Expenses. Total of all expenses incurred2015-12-31$335,023
Benefits paid (including direct rollovers)2015-12-31$335,023
Total plan assets at end of year2015-12-31$2,480,832
Total plan assets at beginning of year2015-12-31$2,786,919
Value of fidelity bond covering the plan2015-12-31$300,000
Total contributions received or receivable from participants2015-12-31$88,327
Other income received2015-12-31$-59,391
Net income (gross income less expenses)2015-12-31$-306,087
Net plan assets at end of year (total assets less liabilities)2015-12-31$2,480,832
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,786,919
Assets. Value of participant loans2015-12-31$9,526
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$240,417
Expenses. Total of all expenses incurred2014-12-31$27,910
Benefits paid (including direct rollovers)2014-12-31$27,910
Total plan assets at end of year2014-12-31$2,786,919
Total plan assets at beginning of year2014-12-31$2,574,412
Value of fidelity bond covering the plan2014-12-31$200,000
Total contributions received or receivable from participants2014-12-31$108,337
Other income received2014-12-31$132,080
Net income (gross income less expenses)2014-12-31$212,507
Net plan assets at end of year (total assets less liabilities)2014-12-31$2,786,919
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$2,574,412
Assets. Value of participant loans2014-12-31$14,210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total income from all sources2013-12-31$533,520
Expenses. Total of all expenses incurred2013-12-31$122,910
Benefits paid (including direct rollovers)2013-12-31$114,792
Total plan assets at end of year2013-12-31$2,574,412
Total plan assets at beginning of year2013-12-31$2,163,802
Value of fidelity bond covering the plan2013-12-31$200,000
Total contributions received or receivable from participants2013-12-31$115,343
Other income received2013-12-31$367,817
Net income (gross income less expenses)2013-12-31$410,610
Net plan assets at end of year (total assets less liabilities)2013-12-31$2,574,412
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$2,163,802
Assets. Value of participant loans2013-12-31$14,603
Total contributions received or receivable from employer(s)2013-12-31$50,360
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$8,118
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0

Form 5500 Responses for ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN

2017: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ELLIOTT BAY ANIMAL HOSPITAL, INC. PS 401(K) RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999311
Policy instance 1
Insurance contract or identification number999311
Number of Individuals Covered49
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,363
Total amount of fees paid to insurance companyUSD $1,399
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $8,363
Insurance broker organization code?3
Amount paid for insurance broker fees1399
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameHUNTER BENEFITS CONSULTING GROUP
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999311
Policy instance 1
Insurance contract or identification number999311
Number of Individuals Covered36
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $7,476
Total amount of fees paid to insurance companyUSD $1,517
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $7,476
Insurance broker organization code?3
Amount paid for insurance broker fees1517
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameHUNTER BENEFITS CONSULTING GROUP
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999311
Policy instance 1
Insurance contract or identification number999311
Number of Individuals Covered52
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,873
Total amount of fees paid to insurance companyUSD $1,300
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $7,873
Insurance broker organization code?3
Amount paid for insurance broker fees1300
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameHUNTER BENEFITS CONSULTING GROUP
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999311
Policy instance 1
Insurance contract or identification number999311
Number of Individuals Covered43
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,970
Total amount of fees paid to insurance companyUSD $1,315
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $7,970
Insurance broker organization code?3
Amount paid for insurance broker fees1315
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameHUNTER BENEFITS CONSULTING GROUP
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number999311
Policy instance 1
Insurance contract or identification number999311
Number of Individuals Covered53
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,385
Total amount of fees paid to insurance companyUSD $573
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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?No
Commission paid to Insurance BrokerUSD $6,844
Insurance broker organization code?3
Amount paid for insurance broker fees573
Additional information about fees paid to insurance brokerTPA FEES
Insurance broker nameADMINISTRATIVE SERVICES, INC.

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