Civic Intelligence
Filing

Group Health and Welfare Plan

Point B Inc. • EIN 26-3473011 • Plan year 2008

Company ProfileSource Archive
Filing Insights

Participants

Up

343 → 373

30 • 8.75%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

-

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
20243552$184,731,347$15,453,407$27,995iApproximate average salary by contribution assumption: employee only about $699,883 at 4% or $466,588 at 6%; with 50% employer match about $466,588 at 4% or $311,059 at 6%; with 100% employer match about $349,941 at 4% or $233,294 at 6%.
Point B 401(K) Plan-537$152,189,179$10,207,684$19,009iApproximate average salary by contribution assumption: employee only about $475,218 at 4% or $316,812 at 6%; with 50% employer match about $316,812 at 4% or $211,208 at 6%; with 100% employer match about $237,609 at 4% or $158,406 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-488$32,542,168$5,245,723$10,749iApproximate average salary by contribution assumption: employee only about $268,736 at 4% or $179,157 at 6%; with 50% employer match about $179,157 at 4% or $119,438 at 6%; with 100% employer match about $134,368 at 4% or $89,579 at 6%.
Group Health and Welfare Plan-552---
202331,416$211,839,886$24,767,428$17,491iApproximate average salary by contribution assumption: employee only about $437,278 at 4% or $291,519 at 6%; with 50% employer match about $291,519 at 4% or $194,346 at 6%; with 100% employer match about $218,639 at 4% or $145,759 at 6%.
Point B 401(K) Plan-671$149,166,564$18,153,837$27,055iApproximate average salary by contribution assumption: employee only about $676,372 at 4% or $450,915 at 6%; with 50% employer match about $450,915 at 4% or $300,610 at 6%; with 100% employer match about $338,186 at 4% or $225,457 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-620$62,673,322$6,613,591$10,667iApproximate average salary by contribution assumption: employee only about $266,677 at 4% or $177,785 at 6%; with 50% employer match about $177,785 at 4% or $118,523 at 6%; with 100% employer match about $133,339 at 4% or $88,892 at 6%.
Group Health and Welfare Plan-1,416---
20223967$270,900,439$26,528,630$27,434iApproximate average salary by contribution assumption: employee only about $685,849 at 4% or $457,233 at 6%; with 50% employer match about $457,233 at 4% or $304,822 at 6%; with 100% employer match about $342,924 at 4% or $228,616 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-645$142,690,764$3,289,460$5,100iApproximate average salary by contribution assumption: employee only about $127,498 at 4% or $84,999 at 6%; with 50% employer match about $84,999 at 4% or $56,666 at 6%; with 100% employer match about $63,749 at 4% or $42,499 at 6%.
Point B 401(K) Plan-967$128,209,675$23,239,170$24,032iApproximate average salary by contribution assumption: employee only about $600,806 at 4% or $400,537 at 6%; with 50% employer match about $400,537 at 4% or $267,025 at 6%; with 100% employer match about $300,403 at 4% or $200,269 at 6%.
Group Health and Welfare Plan-938---
20213790$409,670,227$15,131,151$19,153iApproximate average salary by contribution assumption: employee only about $478,834 at 4% or $319,223 at 6%; with 50% employer match about $319,223 at 4% or $212,815 at 6%; with 100% employer match about $239,417 at 4% or $159,611 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-588$261,715,027$2,500,000$4,252iApproximate average salary by contribution assumption: employee only about $106,293 at 4% or $70,862 at 6%; with 50% employer match about $70,862 at 4% or $47,241 at 6%; with 100% employer match about $53,146 at 4% or $35,431 at 6%.
Point B 401(K) Plan-790$147,955,200$12,631,151$15,989iApproximate average salary by contribution assumption: employee only about $399,720 at 4% or $266,480 at 6%; with 50% employer match about $266,480 at 4% or $177,653 at 6%; with 100% employer match about $199,860 at 4% or $133,240 at 6%.
Group Health and Welfare Plan-790---
20203753$274,449,845$18,518,290$24,593iApproximate average salary by contribution assumption: employee only about $614,817 at 4% or $409,878 at 6%; with 50% employer match about $409,878 at 4% or $273,252 at 6%; with 100% employer match about $307,409 at 4% or $204,939 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-719$140,429,832$5,830,000$8,108iApproximate average salary by contribution assumption: employee only about $202,712 at 4% or $135,141 at 6%; with 50% employer match about $135,141 at 4% or $90,094 at 6%; with 100% employer match about $101,356 at 4% or $67,571 at 6%.
Point B 401(K) Plan-753$134,020,013$12,688,290$16,850iApproximate average salary by contribution assumption: employee only about $421,258 at 4% or $280,839 at 6%; with 50% employer match about $280,839 at 4% or $187,226 at 6%; with 100% employer match about $210,629 at 4% or $140,419 at 6%.
Group Health and Welfare Plan-664---
20194847$220,991,973$18,154,826$21,434iApproximate average salary by contribution assumption: employee only about $535,857 at 4% or $357,238 at 6%; with 50% employer match about $357,238 at 4% or $238,159 at 6%; with 100% employer match about $267,928 at 4% or $178,619 at 6%.
Point B 401(K) Plan-847$119,404,729$12,267,994$14,484iApproximate average salary by contribution assumption: employee only about $362,101 at 4% or $241,401 at 6%; with 50% employer match about $241,401 at 4% or $160,934 at 6%; with 100% employer match about $181,051 at 4% or $120,700 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-640$101,587,244$5,886,832$9,198iApproximate average salary by contribution assumption: employee only about $229,954 at 4% or $153,303 at 6%; with 50% employer match about $153,303 at 4% or $102,202 at 6%; with 100% employer match about $114,977 at 4% or $76,651 at 6%.
Group Health and Welfare Plan-814---
Point B Inc. Flexible Benefits Plan-0---
20184747$190,543,055$17,291,638$23,148iApproximate average salary by contribution assumption: employee only about $578,703 at 4% or $385,802 at 6%; with 50% employer match about $385,802 at 4% or $257,201 at 6%; with 100% employer match about $289,351 at 4% or $192,901 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-601$98,165,726$5,556,000$9,245iApproximate average salary by contribution assumption: employee only about $231,115 at 4% or $154,077 at 6%; with 50% employer match about $154,077 at 4% or $102,718 at 6%; with 100% employer match about $115,557 at 4% or $77,038 at 6%.
Point B 401(K) Plan-747$92,377,329$11,735,638$15,710iApproximate average salary by contribution assumption: employee only about $392,759 at 4% or $261,839 at 6%; with 50% employer match about $261,839 at 4% or $174,560 at 6%; with 100% employer match about $196,379 at 4% or $130,920 at 6%.
Group Health and Welfare Plan-743---
Point B Inc. Flexible Benefits Plan-264---
20174705$159,209,589$15,317,456$21,727iApproximate average salary by contribution assumption: employee only about $543,172 at 4% or $362,115 at 6%; with 50% employer match about $362,115 at 4% or $241,410 at 6%; with 100% employer match about $271,586 at 4% or $181,057 at 6%.
Point B 401(K) Plan-705$90,535,365$10,271,456$14,569iApproximate average salary by contribution assumption: employee only about $364,236 at 4% or $242,824 at 6%; with 50% employer match about $242,824 at 4% or $161,883 at 6%; with 100% employer match about $182,118 at 4% or $121,412 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-538$68,674,224$5,046,000$9,379iApproximate average salary by contribution assumption: employee only about $234,480 at 4% or $156,320 at 6%; with 50% employer match about $156,320 at 4% or $104,213 at 6%; with 100% employer match about $117,240 at 4% or $78,160 at 6%.
Group Health and Welfare Plan-691---
Point B Inc. Flexible Benefits Plan-269---
20164627$129,429,123$12,198,717$19,456iApproximate average salary by contribution assumption: employee only about $486,392 at 4% or $324,261 at 6%; with 50% employer match about $324,261 at 4% or $216,174 at 6%; with 100% employer match about $243,196 at 4% or $162,131 at 6%.
Point B 401(K) Plan-627$71,605,615$7,674,717$12,240iApproximate average salary by contribution assumption: employee only about $306,009 at 4% or $204,006 at 6%; with 50% employer match about $204,006 at 4% or $136,004 at 6%; with 100% employer match about $153,005 at 4% or $102,003 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-486$57,823,508$4,524,000$9,309iApproximate average salary by contribution assumption: employee only about $232,716 at 4% or $155,144 at 6%; with 50% employer match about $155,144 at 4% or $103,429 at 6%; with 100% employer match about $116,358 at 4% or $77,572 at 6%.
Point B Inc. Flexible Benefits Plan-331---
Group Health and Welfare Plan-503---
20154580$107,673,077$11,439,119$19,723iApproximate average salary by contribution assumption: employee only about $493,065 at 4% or $328,710 at 6%; with 50% employer match about $328,710 at 4% or $219,140 at 6%; with 100% employer match about $246,533 at 4% or $164,355 at 6%.
Point B 401(K) Plan-580$64,955,807$7,507,434$12,944iApproximate average salary by contribution assumption: employee only about $323,596 at 4% or $215,731 at 6%; with 50% employer match about $215,731 at 4% or $143,821 at 6%; with 100% employer match about $161,798 at 4% or $107,865 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-453$42,717,270$3,931,685$8,679iApproximate average salary by contribution assumption: employee only about $216,980 at 4% or $144,654 at 6%; with 50% employer match about $144,654 at 4% or $96,436 at 6%; with 100% employer match about $108,490 at 4% or $72,327 at 6%.
Group Health and Welfare Plan-527---
Point B Inc. Flexible Benefits Plan-391---
20144558$89,622,794$10,087,385$18,078iApproximate average salary by contribution assumption: employee only about $451,944 at 4% or $301,296 at 6%; with 50% employer match about $301,296 at 4% or $200,864 at 6%; with 100% employer match about $225,972 at 4% or $150,648 at 6%.
Point B 401(K) Plan-558$62,888,340$6,586,884$11,804iApproximate average salary by contribution assumption: employee only about $295,111 at 4% or $196,741 at 6%; with 50% employer match about $196,741 at 4% or $131,161 at 6%; with 100% employer match about $147,556 at 4% or $98,370 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-415$26,734,454$3,500,501$8,435iApproximate average salary by contribution assumption: employee only about $210,874 at 4% or $140,582 at 6%; with 50% employer match about $140,582 at 4% or $93,722 at 6%; with 100% employer match about $105,437 at 4% or $70,291 at 6%.
Group Health and Welfare Plan-514---
Point B Inc. Flexible Benefits Plan-380---
20133497$69,818,506$9,197,439$18,506iApproximate average salary by contribution assumption: employee only about $462,648 at 4% or $308,432 at 6%; with 50% employer match about $308,432 at 4% or $205,621 at 6%; with 100% employer match about $231,324 at 4% or $154,216 at 6%.
Point B 401(K) Plan-497$54,938,625$6,697,439$13,476iApproximate average salary by contribution assumption: employee only about $336,893 at 4% or $224,596 at 6%; with 50% employer match about $224,596 at 4% or $149,730 at 6%; with 100% employer match about $168,447 at 4% or $112,298 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-376$14,879,881$2,500,000$6,649iApproximate average salary by contribution assumption: employee only about $166,223 at 4% or $110,816 at 6%; with 50% employer match about $110,816 at 4% or $73,877 at 6%; with 100% employer match about $83,112 at 4% or $55,408 at 6%.
Point B Inc. Flexible Benefits Plan-360---
20124477$56,798,599$7,657,998$16,055iApproximate average salary by contribution assumption: employee only about $401,363 at 4% or $267,575 at 6%; with 50% employer match about $267,575 at 4% or $178,383 at 6%; with 100% employer match about $200,681 at 4% or $133,788 at 6%.
Point B 401(K) Plan-477$41,005,780$5,657,998$11,862iApproximate average salary by contribution assumption: employee only about $296,541 at 4% or $197,694 at 6%; with 50% employer match about $197,694 at 4% or $131,796 at 6%; with 100% employer match about $148,270 at 4% or $98,847 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-367$15,792,819$2,000,000$5,450iApproximate average salary by contribution assumption: employee only about $136,240 at 4% or $90,827 at 6%; with 50% employer match about $90,827 at 4% or $60,551 at 6%; with 100% employer match about $68,120 at 4% or $45,413 at 6%.
Point B Inc. Flexible Benefits Plan-338---
Group Health and Welfare Plan-436---
20114431$49,336,660$7,744,562$17,969iApproximate average salary by contribution assumption: employee only about $449,221 at 4% or $299,480 at 6%; with 50% employer match about $299,480 at 4% or $199,654 at 6%; with 100% employer match about $224,610 at 4% or $149,740 at 6%.
Point B 401(K) Plan-431$33,165,456$4,744,562$11,008iApproximate average salary by contribution assumption: employee only about $275,207 at 4% or $183,471 at 6%; with 50% employer match about $183,471 at 4% or $122,314 at 6%; with 100% employer match about $137,603 at 4% or $91,736 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-336$16,171,204$3,000,000$8,929iApproximate average salary by contribution assumption: employee only about $223,214 at 4% or $148,810 at 6%; with 50% employer match about $148,810 at 4% or $99,206 at 6%; with 100% employer match about $111,607 at 4% or $74,405 at 6%.
Group Health and Welfare Plan-416---
Point B Inc. Flexible Benefits Plan-373---
20104401$42,027,169$7,832,834$19,533iApproximate average salary by contribution assumption: employee only about $488,331 at 4% or $325,554 at 6%; with 50% employer match about $325,554 at 4% or $217,036 at 6%; with 100% employer match about $244,166 at 4% or $162,777 at 6%.
Point B 401(K) Plan-401$31,230,895$4,776,233$11,911iApproximate average salary by contribution assumption: employee only about $297,770 at 4% or $198,513 at 6%; with 50% employer match about $198,513 at 4% or $132,342 at 6%; with 100% employer match about $148,885 at 4% or $99,257 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-320$10,796,274$3,056,601$9,552iApproximate average salary by contribution assumption: employee only about $238,797 at 4% or $159,198 at 6%; with 50% employer match about $159,198 at 4% or $106,132 at 6%; with 100% employer match about $119,398 at 4% or $79,599 at 6%.
Group Health and Welfare Plan-393---
Point B Inc. Flexible Benefits Plan-341---
20093346$8,679,981$3,000,000$8,671iApproximate average salary by contribution assumption: employee only about $216,763 at 4% or $144,509 at 6%; with 50% employer match about $144,509 at 4% or $96,339 at 6%; with 100% employer match about $108,382 at 4% or $72,254 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-343$8,679,981$3,000,000$8,746iApproximate average salary by contribution assumption: employee only about $218,659 at 4% or $145,773 at 6%; with 50% employer match about $145,773 at 4% or $97,182 at 6%; with 100% employer match about $109,329 at 4% or $72,886 at 6%.
Group Health and Welfare Plan-346---
Point B Inc. Flexible Benefits Plan-285---
20082381$13,920,000$3,000,000$7,874iApproximate average salary by contribution assumption: employee only about $196,850 at 4% or $131,234 at 6%; with 50% employer match about $131,234 at 4% or $87,489 at 6%; with 100% employer match about $98,425 at 4% or $65,617 at 6%.
Point B Inc. Employee Stock Ownership Plan and Trust-381$13,920,000$3,000,000$7,874iApproximate average salary by contribution assumption: employee only about $196,850 at 4% or $131,234 at 6%; with 50% employer match about $131,234 at 4% or $87,489 at 6%; with 100% employer match about $98,425 at 4% or $65,617 at 6%.
Group Health and Welfare PlanCurrent373---
Schedule Details

Schedule A

Row 1
Filing Id
84037260124029
Form Id
98258814
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
8010379260124020002
Ins Broker 01 Name
KIBBLE & PRENTICE HOLDING COMPANY
Ins Broker 01 Street Addr
601 UNION ST STE 1000
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
981014064
Ins Broker Comm Pd 01 Amount
$15,828
Ins Broker Fees Pd 01 Amount
$5,000
Ins Broker Fees Pd 01 Text
BONUS
Ins Broker 01 Code
3
Row 2
Filing Id
84037260124029
Form Id
98258816
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
8010379260124020004
Ins Broker 01 Name
KIBBLE & PRENTICE HOLDING COMPANY
Ins Broker 01 Street Addr
601 UNION ST STE 1000
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
981014064
Ins Broker Comm Pd 01 Amount
$1,613
Ins Broker Fees Pd 01 Amount
$0
Ins Broker 01 Code
3
Row 3
Filing Id
84037260124029
Form Id
98258815
Page Id
2
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
8010379260124020003
Ins Broker 01 Name
KIBBLE & PRENTICE HOLDING COMPANY
Ins Broker 01 Street Addr
601 UNION ST STE 1000
Ins Broker 01 City
SEATTLE
Ins Broker 01 State
WA
Ins Broker 01 ZIP Code
981014064
Ins Broker Comm Pd 01 Amount
$60,251
Ins Broker Fees Pd 01 Amount
$9,790
Ins Broker Fees Pd 01 Text
BONUS
Ins Broker 01 Code
3
Row 4
Ins Carrier Name: UNION SECURITY INSURANCE COMPANY
Filing Id
84037260124029
Form Id
98258814
Schedule A EIN
26-3473011
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2008-01-01
Schedule A Tax Period
20081231
Ins Carrier Name
UNION SECURITY INSURANCE COMPANY
Ins Carrier EIN
81-0170040
Ins Carrier Naic Code
70408
Ins Contract Num
5225281
Ins Prsn Covered End of year Count
202
Ins Policy From Date
2008-01-01
Ins Policy To Date
2008-12-31
Ins Broker Comm Total Amount
$15,828
Ins Broker Fees Total Amount
$5,000
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
B
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$197,855
Wlfr Acquis Cost Amount
$0
Row 5
Ins Carrier Name: VISION SERVICE PLAN
Filing Id
84037260124029
Form Id
98258816
Schedule A EIN
26-3473011
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2008-01-01
Schedule A Tax Period
20081231
Ins Carrier Name
VISION SERVICE PLAN
Ins Carrier EIN
91-6056925
Ins Carrier Naic Code
47317
Ins Contract Num
30001381
Ins Prsn Covered End of year Count
361
Ins Policy From Date
2008-01-01
Ins Policy To Date
2008-12-31
Ins Broker Comm Total Amount
$1,613
Ins Broker Fees Total Amount
$0
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
C
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$38,976
Wlfr Acquis Cost Amount
$0
Row 6
Ins Carrier Name: UNION SECURITY INSURANCE COMPANY
Filing Id
84037260124029
Form Id
98258815
Schedule A EIN
26-3473011
Schedule A Plan Num
501
Schedule A Plan Year Begin Date
2008-01-01
Schedule A Tax Period
20081231
Ins Carrier Name
UNION SECURITY INSURANCE COMPANY
Ins Carrier EIN
81-0170040
Ins Carrier Naic Code
70408
Ins Contract Num
G4042506
Ins Prsn Covered End of year Count
373
Ins Policy From Date
2008-01-01
Ins Policy To Date
2008-12-31
Ins Broker Comm Total Amount
$60,251
Ins Broker Fees Total Amount
$9,790
Pension End of year Gen Account Amount
$0
Pension End of year Sep Account Amount
$0
Pension Prem Paid Total Amount
$0
Pension Unpaid Premium Amount
$0
Pension Contract Cost Amount
$0
Pension End Prev Bal Amount
$0
Pension Contribution Dep Amount
$0
Pension Divnd Cr Dep Amount
$0
Pension Interest Cr Dur Yr Amount
$0
Pension Transfer From Amount
$0
Pension Other Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Bnfts Dsbrsd Amount
$0
Pension Admin Chrg Amount
$0
Pension Transfer To Amount
$0
Pension Oth Ded Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Type Bnft Indicator
DEFM
Wlfr Type Bnft Oth Text
AD&D
Wlfr Premium Rcvd Amount
$0
Wlfr Unpaid Due Amount
$0
Wlfr Reserve Amount
$0
Wlfr Total Earned Prem Amount
$0
Wlfr Claims Paid Amount
$0
Wlfr Incr Reserve Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Claims Chrgd Amount
$0
Wlfr Ret Commissions Amount
$0
Wlfr Ret Admin Amount
$0
Wlfr Ret Oth Cost Amount
$0
Wlfr Ret Oth Expense Amount
$0
Wlfr Ret Taxes Amount
$0
Wlfr Ret Charges Amount
$0
Wlfr Ret Oth Chrgs Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Amount
$0
Wlfr Held Bnfts Amount
$0
Wlfr Claims Reserve Amount
$0
Wlfr Oth Reserve Amount
$0
Wlfr Divnds Due Amount
$0
Wlfr Total Charges Paid Amount
$393,435
Wlfr Acquis Cost Amount
$0

Schedule C

Schedule C Provider

Provider 1

Provider details

Source fields
Row 1
Filing Id
84037260124029
Page Id
1
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
8010379260124020005
Provider 01 Name
GREAT-WEST HEALTHCARE
Provider 01 EIN
84-0467907
Provider 01 Position
CONTRACT ADMINISTRATOR
Provider 01 Relation
NONE
Provider 01 Salary Amount
$0
Provider 01 Fees Amount
$252,355
Provider 01 Srvc Code
12
Row 2
Filing Id
84037260124029
Page Id
3
Page Seq
0
Page Row Num
1
Row Num
0
Image Form Id
8010379260124020005

Schedule C Provider

Provider 2

Provider details

Source fields
Row 3
Filing Id
84037260124029
Page Id
1
Page Seq
0
Page Row Num
2
Row Num
1
Image Form Id
8010379260124020005
Provider 01 Name
KIBBLE & PRENTICE HOLDING COMPANY
Provider 01 EIN
91-1176315
Provider 01 Position
INSURANCE BROKER
Provider 01 Relation
NONE
Provider 01 Salary Amount
$0
Provider 01 Fees Amount
$84,956
Provider 01 Srvc Code
19

Schedule C Provider

Provider 3

Provider details

Source fields
Row 4
Filing Id
84037260124029
Schedule C EIN
26-3473011
Schedule C Plan number
501
Schedule C Plan Year Begin Date
2008-01-01
Schedule C Tax Period
20081231
Provider Total Comp Paid Amount
$0