E&B NATURAL RESOURCES MANAGEMENT CORP. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN
401k plan membership statisitcs for E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-05-01 | 312 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 303 |
Total of all active and inactive participants | 2022-05-01 | 303 |
Total participants | 2022-05-01 | 303 |
2021: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-05-01 | 434 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 312 |
Number of retired or separated participants receiving benefits | 2021-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
Total of all active and inactive participants | 2021-05-01 | 312 |
Total participants | 2021-05-01 | 312 |
2020: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 362 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 338 |
Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
Total of all active and inactive participants | 2020-05-01 | 338 |
Total participants | 2020-05-01 | 338 |
2019: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-05-01 | 424 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 424 |
Number of retired or separated participants receiving benefits | 2019-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 0 |
Total of all active and inactive participants | 2019-05-01 | 424 |
Total participants | 2019-05-01 | 424 |
2018: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-05-01 | 415 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 424 |
Total of all active and inactive participants | 2018-05-01 | 424 |
Total participants | 2018-05-01 | 424 |
2017: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 384 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 402 |
Number of retired or separated participants receiving benefits | 2017-05-01 | 5 |
Total of all active and inactive participants | 2017-05-01 | 407 |
Total participants | 2017-05-01 | 407 |
2016: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 367 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 350 |
Number of retired or separated participants receiving benefits | 2016-05-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
Total of all active and inactive participants | 2016-05-01 | 353 |
Total participants | 2016-05-01 | 353 |
2015: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 408 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 367 |
Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-05-01 | 0 |
Total of all active and inactive participants | 2015-05-01 | 367 |
2014: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 408 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 406 |
Number of retired or separated participants receiving benefits | 2014-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-05-01 | 0 |
Total of all active and inactive participants | 2014-05-01 | 406 |
2013: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 408 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 408 |
Total of all active and inactive participants | 2013-05-01 | 408 |
2012: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 335 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 538 |
Total of all active and inactive participants | 2012-05-01 | 538 |
2011: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 280 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 335 |
Total of all active and inactive participants | 2011-05-01 | 335 |
2010: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-05-01 | 267 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 280 |
Total of all active and inactive participants | 2010-05-01 | 280 |
2009: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 251 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 241 |
Total of all active and inactive participants | 2009-05-01 | 241 |
Total participants, beginning-of-year | 2009-01-01 | 22 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 20 |
Total of all active and inactive participants | 2009-01-01 | 20 |
Total participants | 2009-01-01 | 20 |
2022: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2022 form 5500 responses |
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2022-05-01 | Type of plan entity | Single employer plan |
2022-05-01 | Submission has been amended | No |
2022-05-01 | This submission is the final filing | No |
2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-05-01 | Plan is a collectively bargained plan | No |
2022-05-01 | Plan funding arrangement – Insurance | Yes |
2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-05-01 | Plan benefit arrangement – Insurance | Yes |
2022-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2021 form 5500 responses |
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2021-05-01 | Type of plan entity | Single employer plan |
2021-05-01 | Submission has been amended | No |
2021-05-01 | This submission is the final filing | No |
2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-05-01 | Plan is a collectively bargained plan | No |
2021-05-01 | Plan funding arrangement – Insurance | Yes |
2021-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-05-01 | Plan benefit arrangement – Insurance | Yes |
2021-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Submission has been amended | No |
2020-05-01 | This submission is the final filing | No |
2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-05-01 | Plan is a collectively bargained plan | No |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2019 form 5500 responses |
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2019-05-01 | Type of plan entity | Single employer plan |
2019-05-01 | Submission has been amended | No |
2019-05-01 | This submission is the final filing | No |
2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-05-01 | Plan is a collectively bargained plan | No |
2019-05-01 | Plan funding arrangement – Insurance | Yes |
2019-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-05-01 | Plan benefit arrangement – Insurance | Yes |
2019-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2018 form 5500 responses |
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2018-05-01 | Type of plan entity | Single employer plan |
2018-05-01 | Submission has been amended | No |
2018-05-01 | This submission is the final filing | No |
2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-05-01 | Plan is a collectively bargained plan | No |
2018-05-01 | Plan funding arrangement – Insurance | Yes |
2018-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-05-01 | Plan benefit arrangement – Insurance | Yes |
2018-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Submission has been amended | No |
2017-05-01 | This submission is the final filing | No |
2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-05-01 | Plan is a collectively bargained plan | No |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Submission has been amended | No |
2016-05-01 | This submission is the final filing | No |
2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-05-01 | Plan is a collectively bargained plan | No |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2014: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2013: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-05-01 | Type of plan entity | Single employer plan |
2013-05-01 | Plan funding arrangement – Insurance | Yes |
2013-05-01 | Plan benefit arrangement – Insurance | Yes |
2012: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2012 form 5500 responses |
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2012-05-01 | Type of plan entity | Single employer plan |
2012-05-01 | Plan funding arrangement – Insurance | Yes |
2012-05-01 | Plan benefit arrangement – Insurance | Yes |
2011: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2011 form 5500 responses |
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2011-05-01 | Type of plan entity | Single employer plan |
2011-05-01 | Plan funding arrangement – Insurance | Yes |
2011-05-01 | Plan benefit arrangement – Insurance | Yes |
2010: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2010 form 5500 responses |
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2010-05-01 | Type of plan entity | Single employer plan |
2010-05-01 | Plan funding arrangement – Insurance | Yes |
2010-05-01 | Plan benefit arrangement – Insurance | Yes |
2009: E&B NATURAL RESOURCES MANAGEMENT WELFARE BENEFIT PLAN 2009 form 5500 responses |
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2009-05-01 | Type of plan entity | Single employer plan |
2009-05-01 | This submission is the final filing | No |
2009-05-01 | Plan funding arrangement – Insurance | Yes |
2009-05-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | First time form 5500 has been submitted | Yes |
2009-01-01 | Submission has been amended | Yes |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Trust | Yes |
2009-01-01 | Plan benefit arrangement - Trust | Yes |
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 3 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 180 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2023-04-30 | Total amount of commissions paid to insurance broker | USD $37,233 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,045,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $37,233 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 168970 |
Policy instance | 2 |
Insurance contract or identification number | 168970 | Number of Individuals Covered | 303 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2023-04-30 | Total amount of commissions paid to insurance broker | USD $30,359 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,025 | Insurance broker organization code? | 3 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 279627 |
Policy instance | 1 |
Insurance contract or identification number | 279627 | Number of Individuals Covered | 186 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2023-04-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,847 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | G0360 |
Policy instance | 3 |
Insurance contract or identification number | G0360 | Number of Individuals Covered | 178 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-04-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,702 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 168970 |
Policy instance | 2 |
Insurance contract or identification number | 168970 | Number of Individuals Covered | 312 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $33,587 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $335,866 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,587 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 290 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $52,494 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,531,824 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,494 |
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GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00538687 |
Policy instance | 1 |
Insurance contract or identification number | 00538687 | Number of Individuals Covered | 338 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $39,135 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $39,135 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 2 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 368 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $55,078 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,332,293 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $55,078 | Insurance broker organization code? | 3 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | G0360 |
Policy instance | 3 |
Insurance contract or identification number | G0360 | Number of Individuals Covered | 198 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,266 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 399 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $77,662 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,873,007 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $77,662 | Insurance broker organization code? | 3 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 279627 |
Policy instance | 2 |
Insurance contract or identification number | 279627 | Number of Individuals Covered | 242 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00538687 |
Policy instance | 3 |
Insurance contract or identification number | 00538687 | Number of Individuals Covered | 424 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $49,854 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | SHORT TERM DISABILITY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $498,543 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,854 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 424 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $81,662 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,029,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81,662 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00538687 |
Policy instance | 2 |
Insurance contract or identification number | 00538687 | Number of Individuals Covered | 424 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $45,054 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $450,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,505 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 279627 |
Policy instance | 3 |
Insurance contract or identification number | 279627 | Number of Individuals Covered | 219 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,135 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 20 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $17 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17 | Insurance broker organization code? | 3 | Insurance broker name | SNITCHLER STEPHEN L |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00538687 |
Policy instance | 3 |
Insurance contract or identification number | 00538687 | Number of Individuals Covered | 402 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $36,358 | Total amount of fees paid to insurance company | USD $3,237 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $363,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,358 | Amount paid for insurance broker fees | 3237 | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 279627 |
Policy instance | 2 |
Insurance contract or identification number | 279627 | Number of Individuals Covered | 186 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $7,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 154 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $71,594 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,847,142 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71,594 | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INSURANCE |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 279627 |
Policy instance | 5 |
Insurance contract or identification number | 279627 | Number of Individuals Covered | 183 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,409 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD. |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 367 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $78,935 | Welfare Benefit Premiums Paid to Carrier | USD $1,972,185 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $78,935 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INS. SERVIC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 2 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 407 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $6,770 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $135,409 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,770 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 3 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 406 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $2,245 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,890 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,245 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 406 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $1,046 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,924 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,046 | Additional information about fees paid to insurance broker | COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 3 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 405 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $3,652 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,652 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 541 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $67,457 | Welfare Benefit Premiums Paid to Carrier | USD $1,687,430 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $67,457 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INS. SERVIC |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 2 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 406 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $11,705 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $234,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,705 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 405 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $1,707 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,126 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,707 | Additional information about fees paid to insurance broker | COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3337898 |
Policy instance | 5 |
Insurance contract or identification number | 3337898 | Number of Individuals Covered | 221 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $136,688 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,037,504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $136,688 | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD. |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 407 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $1,607 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,607 | Additional information about fees paid to insurance broker | COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 596 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $68,306 | Welfare Benefit Premiums Paid to Carrier | USD $1,707,679 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,306 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INS. SERVIC |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 2 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 408 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $11,053 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $220,835 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,053 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 3 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 407 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $3,567 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $71,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,567 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 2 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 397 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $9,013 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $180,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,013 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 3 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 397 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $2,580 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $51,608 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,580 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 393 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $1,259 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $25,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,259 | Additional information about fees paid to insurance broker | COMMISSIONS PAID | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN SNITCHLER |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 1 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 538 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $66,043 | Welfare Benefit Premiums Paid to Carrier | USD $1,652,857 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66,043 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INS. SERVIC |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 2 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 173 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $58,537 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,386,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 166270 |
Policy instance | 1 |
Insurance contract or identification number | 166270 | Number of Individuals Covered | 162 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $78,042 | Total amount of fees paid to insurance company | USD $15,608 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,773,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 3 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 308 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $8,079 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $162,393 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 4 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 308 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $1,985 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,705 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214404 |
Policy instance | 5 |
Insurance contract or identification number | 214404 | Number of Individuals Covered | 308 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $970 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 229252 |
Policy instance | 2 |
Insurance contract or identification number | 229252 | Number of Individuals Covered | 136 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $41,291 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,070,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,291 | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD DBA KERN ISLAND INS. SERVIC |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 166270 |
Policy instance | 1 |
Insurance contract or identification number | 166270 | Number of Individuals Covered | 131 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $76,311 | Total amount of fees paid to insurance company | USD $4,919 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,521,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76,311 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4919 | Insurance broker name | WARNER PACIFIC INS. SERVICES |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 860736G |
Policy instance | 3 |
Insurance contract or identification number | 860736G | Number of Individuals Covered | 8 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $4,174 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,476 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,174 | Insurance broker organization code? | 3 | Insurance broker name | BXB LTD |
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