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NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameNEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NEW GENERATION WELLNESS, INC. has sponsored the creation of one or more 401k plans.

Company Name:NEW GENERATION WELLNESS, INC.
Employer identification number (EIN):950494000
NAIC Classification:325410

Additional information about NEW GENERATION WELLNESS, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2011-04-15
Company Identification Number: P11000037117
Legal Registered Office Address: 97 ROSE BAY COURT

ROYAL PALM BEACH

33411

More information about NEW GENERATION WELLNESS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01STEVER WYCHULIS2023-10-05
5012021-01-01REBECCA RYAN2022-08-25
5012020-01-01REBECCA RYAN2021-07-16
5012019-01-01REBECCA RYAN2020-06-29
5012018-01-01
5012017-01-01
5012016-01-01JEAN ALFIERI
5012015-01-01JEAN ALFIERI
5012014-01-01JEAN ALFIERI
5012013-01-01JEAN ALFIERI
5012012-01-01REBECCA RYAN
5012011-01-01JEAN ALFIERI
5012010-01-01MARK T NISHI
5012009-01-01MARK T NISHI
5012008-01-01MARK T NISHI
5012007-01-01MARK T NISHI
5012006-01-01MARK T NISHI
5012005-01-01MARK T NISHI
5012004-01-01MARK T NISHI
5012003-01-01MARK T NISHI
5012002-01-01MARK T NISHI
5012001-01-01MARK T NISHI
5012000-01-01MARK T NISHI
5011999-01-01MARK T NISHI
5011998-01-01MARK T NISHI
5011997-01-01MARK T NISHI
5011997-01-01MARK T NISHI
5011996-01-01MARK T NISHI
5011995-01-01MARK T NISHI
5011994-01-01MARK T NISHI
5011993-01-01MARK T NISHI
5011992-01-01MARK T NISHI
5011991-01-01MARK T. NISHI

Plan Statistics for NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2022: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01260
Total number of active participants reported on line 7a of the Form 55002022-01-01220
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01220
Number of employers contributing to the scheme2022-01-010
2021: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01292
Total number of active participants reported on line 7a of the Form 55002021-01-01267
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-0111
Total of all active and inactive participants2021-01-01279
Number of employers contributing to the scheme2021-01-010
2020: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01320
Total number of active participants reported on line 7a of the Form 55002020-01-01262
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01263
Number of employers contributing to the scheme2020-01-010
2019: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01334
Total number of active participants reported on line 7a of the Form 55002019-01-01319
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01320
Number of employers contributing to the scheme2019-01-010
2018: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01418
Total number of active participants reported on line 7a of the Form 55002018-01-01411
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-0119
Total of all active and inactive participants2018-01-01431
Number of employers contributing to the scheme2018-01-010
2017: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01452
Total number of active participants reported on line 7a of the Form 55002017-01-01425
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-0122
Total of all active and inactive participants2017-01-01450
2016: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01181
Total number of active participants reported on line 7a of the Form 55002016-01-01431
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01431
2015: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01299
Total number of active participants reported on line 7a of the Form 55002015-01-01173
Number of retired or separated participants receiving benefits2015-01-018
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01181
2014: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01243
Total number of active participants reported on line 7a of the Form 55002014-01-01299
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01299
2013: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01248
Total number of active participants reported on line 7a of the Form 55002013-01-01239
Number of retired or separated participants receiving benefits2013-01-014
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01243
2012: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0144
Total number of active participants reported on line 7a of the Form 55002012-01-0142
Total of all active and inactive participants2012-01-0142
Total participants2012-01-0142
2011: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01262
Total number of active participants reported on line 7a of the Form 55002011-01-01237
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01237
2010: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01263
Total number of active participants reported on line 7a of the Form 55002010-01-01262
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01262
2009: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01125
Total number of active participants reported on line 7a of the Form 55002009-01-01263
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01263
2008: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01174
Total number of active participants reported on line 7a of the Form 55002008-01-01125
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01125
2007: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01136
Total number of active participants reported on line 7a of the Form 55002007-01-01174
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01174
2006: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01118
Total number of active participants reported on line 7a of the Form 55002006-01-01136
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01136
2005: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01124
Total number of active participants reported on line 7a of the Form 55002005-01-01118
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01118
2004: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01120
Total number of active participants reported on line 7a of the Form 55002004-01-01124
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-01124
2003: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01118
Total number of active participants reported on line 7a of the Form 55002003-01-01120
Number of retired or separated participants receiving benefits2003-01-010
Number of other retired or separated participants entitled to future benefits2003-01-010
Total of all active and inactive participants2003-01-01120
2002: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01116
Total number of active participants reported on line 7a of the Form 55002002-01-01118
Number of retired or separated participants receiving benefits2002-01-010
Number of other retired or separated participants entitled to future benefits2002-01-010
Total of all active and inactive participants2002-01-01118
2001: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01115
Total number of active participants reported on line 7a of the Form 55002001-01-01116
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-01116
2000: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01113
Total number of active participants reported on line 7a of the Form 55002000-01-01115
Number of retired or separated participants receiving benefits2000-01-010
Number of other retired or separated participants entitled to future benefits2000-01-010
Total of all active and inactive participants2000-01-01115
1999: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01112
Total number of active participants reported on line 7a of the Form 55001999-01-01113
Number of retired or separated participants receiving benefits1999-01-010
Number of other retired or separated participants entitled to future benefits1999-01-010
Total of all active and inactive participants1999-01-01113
1998: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01110
Total number of active participants reported on line 7a of the Form 55001998-01-01112
Number of retired or separated participants receiving benefits1998-01-010
Number of other retired or separated participants entitled to future benefits1998-01-010
Total of all active and inactive participants1998-01-01112
1997: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01109
Total number of active participants reported on line 7a of the Form 55001997-01-01110
Number of retired or separated participants receiving benefits1997-01-010
Number of other retired or separated participants entitled to future benefits1997-01-010
Total of all active and inactive participants1997-01-01110
1996: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01107
Total number of active participants reported on line 7a of the Form 55001996-01-01109
Number of retired or separated participants receiving benefits1996-01-010
Number of other retired or separated participants entitled to future benefits1996-01-010
Total of all active and inactive participants1996-01-01109
1995: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1995 401k membership
Total participants, beginning-of-year1995-01-01106
Total number of active participants reported on line 7a of the Form 55001995-01-01107
Number of retired or separated participants receiving benefits1995-01-010
Number of other retired or separated participants entitled to future benefits1995-01-010
Total of all active and inactive participants1995-01-01107
1994: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1994 401k membership
Total participants, beginning-of-year1994-01-01104
Total number of active participants reported on line 7a of the Form 55001994-01-01106
Number of retired or separated participants receiving benefits1994-01-010
Number of other retired or separated participants entitled to future benefits1994-01-010
Total of all active and inactive participants1994-01-01106
1993: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1993 401k membership
Total participants, beginning-of-year1993-01-01103
Total number of active participants reported on line 7a of the Form 55001993-01-01104
Number of retired or separated participants receiving benefits1993-01-010
Number of other retired or separated participants entitled to future benefits1993-01-010
Total of all active and inactive participants1993-01-01104
1992: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1992 401k membership
Total participants, beginning-of-year1992-01-01101
Total number of active participants reported on line 7a of the Form 55001992-01-01103
Number of retired or separated participants receiving benefits1992-01-010
Number of other retired or separated participants entitled to future benefits1992-01-010
Total of all active and inactive participants1992-01-01103
1991: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1991 401k membership
Total participants, beginning-of-year1991-01-01100
Total number of active participants reported on line 7a of the Form 55001991-01-01101
Number of retired or separated participants receiving benefits1991-01-010
Number of other retired or separated participants entitled to future benefits1991-01-010
Total of all active and inactive participants1991-01-01101

Financial Data on NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2012 : NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2012 401k financial data
Total income from all sources2012-12-31$63,187
Expenses. Total of all expenses incurred2012-12-31$60,155
Benefits paid (including direct rollovers)2012-12-31$60,155
Total plan assets at end of year2012-12-31$3,032
Value of fidelity bond covering the plan2012-12-31$5,000
Total contributions received or receivable from participants2012-12-31$63,187
Net income (gross income less expenses)2012-12-31$3,032
Net plan assets at end of year (total assets less liabilities)2012-12-31$3,032
2011 : NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2011 401k financial data
Total income from all sources2011-12-31$59,833
Expenses. Total of all expenses incurred2011-12-31$56,570
Benefits paid (including direct rollovers)2011-12-31$56,570
Total plan assets at end of year2011-12-31$3,263
Value of fidelity bond covering the plan2011-12-31$5,000
Total contributions received or receivable from participants2011-12-31$59,833
Net income (gross income less expenses)2011-12-31$3,263
Net plan assets at end of year (total assets less liabilities)2011-12-31$3,263
2010 : NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2010 401k financial data
Total income from all sources2010-12-31$56,612
Expenses. Total of all expenses incurred2010-12-31$49,168
Benefits paid (including direct rollovers)2010-12-31$49,168
Total plan assets at end of year2010-12-31$7,444
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$5,000
Total contributions received or receivable from participants2010-12-31$56,612
Net income (gross income less expenses)2010-12-31$7,444
Net plan assets at end of year (total assets less liabilities)2010-12-31$7,444
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0

Form 5500 Responses for NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN

2022: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – InsuranceYes
2002: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – InsuranceYes
2001: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – InsuranceYes
2000: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – InsuranceYes
1999: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – InsuranceYes
1998: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – InsuranceYes
1997: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Submission has been amendedYes
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – InsuranceYes
1996: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01Submission has been amendedNo
1996-01-01This submission is the final filingNo
1996-01-01This return/report is a short plan year return/report (less than 12 months)No
1996-01-01Plan is a collectively bargained planNo
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – InsuranceYes
1995: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1995 form 5500 responses
1995-01-01Type of plan entitySingle employer plan
1995-01-01Submission has been amendedNo
1995-01-01This submission is the final filingNo
1995-01-01This return/report is a short plan year return/report (less than 12 months)No
1995-01-01Plan is a collectively bargained planNo
1995-01-01Plan funding arrangement – InsuranceYes
1995-01-01Plan benefit arrangement – InsuranceYes
1994: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1994 form 5500 responses
1994-01-01Type of plan entitySingle employer plan
1994-01-01Submission has been amendedNo
1994-01-01This submission is the final filingNo
1994-01-01This return/report is a short plan year return/report (less than 12 months)No
1994-01-01Plan is a collectively bargained planNo
1994-01-01Plan funding arrangement – InsuranceYes
1994-01-01Plan benefit arrangement – InsuranceYes
1993: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1993 form 5500 responses
1993-01-01Type of plan entitySingle employer plan
1993-01-01Submission has been amendedNo
1993-01-01This submission is the final filingNo
1993-01-01This return/report is a short plan year return/report (less than 12 months)No
1993-01-01Plan is a collectively bargained planNo
1993-01-01Plan funding arrangement – InsuranceYes
1993-01-01Plan benefit arrangement – InsuranceYes
1992: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1992 form 5500 responses
1992-01-01Type of plan entitySingle employer plan
1992-01-01Submission has been amendedNo
1992-01-01This submission is the final filingNo
1992-01-01This return/report is a short plan year return/report (less than 12 months)No
1992-01-01Plan is a collectively bargained planNo
1992-01-01Plan funding arrangement – InsuranceYes
1992-01-01Plan benefit arrangement – InsuranceYes
1991: NEW GENERATION WELLNESS, INC. HEALTH AND WELFARE PLAN 1991 form 5500 responses
1991-01-01Type of plan entitySingle employer plan
1991-01-01First time form 5500 has been submittedYes
1991-01-01Submission has been amendedNo
1991-01-01This submission is the final filingNo
1991-01-01This return/report is a short plan year return/report (less than 12 months)No
1991-01-01Plan is a collectively bargained planNo
1991-01-01Plan funding arrangement – InsuranceYes
1991-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BPK3
Policy instance 4
Insurance contract or identification numberGLTD0BPK3
Number of Individuals Covered221
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,486
Total amount of fees paid to insurance companyUSD $9,083
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS,ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $134,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,486
Amount paid for insurance broker fees9083
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 3
Insurance contract or identification number907732-001
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14
Total amount of fees paid to insurance companyUSD $1
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $14
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 2
Insurance contract or identification number30029671
Number of Individuals Covered145
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,095
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,095
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number926320
Policy instance 1
Insurance contract or identification number926320
Number of Individuals Covered191
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $78,637
Total amount of fees paid to insurance companyUSD $4,240
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,637
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3343279
Policy instance 1
Insurance contract or identification number3343279
Number of Individuals Covered176
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $89,949
Total amount of fees paid to insurance companyUSD $670
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,798,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $89,949
Amount paid for insurance broker fees670
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 2
Insurance contract or identification number30029671
Number of Individuals Covered160
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,031
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,032
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 3
Insurance contract or identification number907732-001
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $111
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $111
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BPK3
Policy instance 4
Insurance contract or identification numberGLTD0BPK3
Number of Individuals Covered252
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,028
Total amount of fees paid to insurance companyUSD $11,307
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS,ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $140,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,028
Amount paid for insurance broker fees11008
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8540654
Policy instance 1
Insurance contract or identification number8540654
Number of Individuals Covered47
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $42
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $2,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3343279
Policy instance 2
Insurance contract or identification number3343279
Number of Individuals Covered176
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $124,710
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,467,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $88,004
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 3
Insurance contract or identification number30029671
Number of Individuals Covered145
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,245
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $970
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 4
Insurance contract or identification number907732-001
Number of Individuals Covered7
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $187
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $187
Amount paid for insurance broker fees0
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0BPK3
Policy instance 5
Insurance contract or identification numberGLTD0BPK3
Number of Individuals Covered263
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,110
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS,ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $181,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,110
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number49415
Policy instance 8
Insurance contract or identification number49415
Number of Individuals Covered198
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $50,481
Total amount of fees paid to insurance companyUSD $733
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,269,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,481
Amount paid for insurance broker fees733
Additional information about fees paid to insurance brokerLBG BOB BONUS
Insurance broker organization code?3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 7
Insurance contract or identification number907732-001
Number of Individuals Covered18
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $273
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $273
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 6
Insurance contract or identification number30029671
Number of Individuals Covered246
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,430
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,430
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number590497
Policy instance 5
Insurance contract or identification number590497
Number of Individuals Covered319
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803900
Policy instance 4
Insurance contract or identification number803900
Number of Individuals Covered388
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $43,427
Total amount of fees paid to insurance companyUSD $83
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $692,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,427
Amount paid for insurance broker fees83
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
HEALTH AND HUMAN RESOURCES CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number590500
Policy instance 3
Insurance contract or identification number590500
Number of Individuals Covered101
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $221
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $221
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number803900HNO
Policy instance 2
Insurance contract or identification number803900HNO
Number of Individuals Covered170
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $66,670
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,327,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,670
Amount paid for insurance broker fees0
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8540654
Policy instance 1
Insurance contract or identification number8540654
Number of Individuals Covered48
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $238
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $11,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $238
Amount paid for insurance broker fees0
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8540654
Policy instance 1
Insurance contract or identification number8540654
Number of Individuals Covered55
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $303
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $15,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $303
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number803900HNO
Policy instance 2
Insurance contract or identification number803900HNO
Number of Individuals Covered188
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $69,594
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,397,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69,594
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH AND HUMAN RESOURCES CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number590500
Policy instance 3
Insurance contract or identification number590500
Number of Individuals Covered101
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $221
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $221
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803900
Policy instance 4
Insurance contract or identification number803900
Number of Individuals Covered411
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $50,527
Total amount of fees paid to insurance companyUSD $49
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $850,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,527
Amount paid for insurance broker fees49
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number590497
Policy instance 5
Insurance contract or identification number590497
Number of Individuals Covered411
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 6
Insurance contract or identification number30029671
Number of Individuals Covered253
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,476
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,476
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 7
Insurance contract or identification number907732-001
Number of Individuals Covered25
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $366
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $366
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number49415
Policy instance 8
Insurance contract or identification number49415
Number of Individuals Covered188
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $46,337
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,165,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,337
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number803900HNO
Policy instance 2
Insurance contract or identification number803900HNO
Number of Individuals Covered182
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $61,894
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,239,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,894
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
HEALTH AND HUMAN RESOURCES CENTER, INC. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number590500
Policy instance 3
Insurance contract or identification number590500
Number of Individuals Covered101
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $221
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $221
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number803900
Policy instance 4
Insurance contract or identification number803900
Number of Individuals Covered418
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $52,719
Total amount of fees paid to insurance companyUSD $127
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $904,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $52,719
Amount paid for insurance broker fees127
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
AETNA EMPLOYEE ASSISTANCE PLAN (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number590497
Policy instance 5
Insurance contract or identification number590497
Number of Individuals Covered425
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $7,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30029671
Policy instance 6
Insurance contract or identification number30029671
Number of Individuals Covered258
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,487
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,487
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number907732-001
Policy instance 7
Insurance contract or identification number907732-001
Number of Individuals Covered29
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $404
Total amount of fees paid to insurance companyUSD $-1
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $352
Amount paid for insurance broker fees-1
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number49415
Policy instance 8
Insurance contract or identification number49415
Number of Individuals Covered198
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $45,280
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,129,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,280
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8540654
Policy instance 1
Insurance contract or identification number8540654
Number of Individuals Covered61
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $353
Total amount of fees paid to insurance companyUSD $3
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $14,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $353
Amount paid for insurance broker fees3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC

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