RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 401k Plan overview

Plan Name	RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN
Plan identification number	501

RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

RADIOLOGY ASSOC OF TALLAHASSEE, PA has sponsored the creation of one or more 401k plans.

Company Name:	RADIOLOGY ASSOC OF TALLAHASSEE, PA
Employer identification number (EIN):	591268204
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01	LANCE HAMPTON
501	2017-01-01	LANCE HAMPTON
501	2016-01-01	LANCE HAMPTON
501	2015-01-01	LANCE HAMPTON
501	2014-01-01	LANCE HAMPTON
501	2013-01-01	LANCE HAMPTON
501	2012-01-01	LANCE HAMPTON
501	2011-01-01	LANCE HAMPTON
501	2010-01-01	LANCE HAMPTON
501	2009-01-01	LANCE HAMPTON
501	2008-01-01	LANCE HAMPTON
501	2007-01-01	LANCE HAMPTON
501	2006-01-01	LANCE HAMPTON
501	2005-01-01	LANCE HAMPTON
501	2004-01-01	LANCE HAMPTON
501	2003-01-01	LANCE HAMPTON
501	2002-01-01	LANCE HAMPTON

Plan Statistics for RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN

401k plan membership statisitcs for RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN

Measure	Date	Value
2023: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	266
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	266
2022: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	207
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	207
2021: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	197
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	197
2020: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	181
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	181
2019: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	187
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	195
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	195
2018: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	175
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	187
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	187
2017: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	175
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	175
2016: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	163
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	174
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	174
2015: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	163
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	163
2014: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	158
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	158
2013: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	147
Total of all active and inactive participants	2013-01-01	147
2012: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	147
Total of all active and inactive participants	2012-01-01	147
2011: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	147
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	147
2010: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	150
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	150
2009: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	148
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	148
2008: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	197
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	197
2007: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	186
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	186
2006: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	191
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	191
2005: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	188
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	0
Total of all active and inactive participants	2005-01-01	188
2004: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2004 401k membership
Total participants, beginning-of-year	2004-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2004-01-01	180
Number of retired or separated participants receiving benefits	2004-01-01	0
Number of other retired or separated participants entitled to future benefits	2004-01-01	0
Total of all active and inactive participants	2004-01-01	180
2003: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2003 401k membership
Total participants, beginning-of-year	2003-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2003-01-01	173
Number of retired or separated participants receiving benefits	2003-01-01	0
Number of other retired or separated participants entitled to future benefits	2003-01-01	0
Total of all active and inactive participants	2003-01-01	173
2002: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2002 401k membership
Total participants, beginning-of-year	2002-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2002-01-01	162
Number of retired or separated participants receiving benefits	2002-01-01	0
Number of other retired or separated participants entitled to future benefits	2002-01-01	0
Total of all active and inactive participants	2002-01-01	162

Financial Data on RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN

Measure	Date	Value
2023 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2023 401k financial data
Total income from all sources (including contributions)	2023-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Was this plan covered by a fidelity bond	2023-12-31	No
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Did the plan have assets held for investment	2023-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
2022 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	No
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Did the plan have assets held for investment	2022-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
2021 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	No
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Did the plan have assets held for investment	2021-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
2020 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	No
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Did the plan have assets held for investment	2020-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
2019 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Did the plan have assets held for investment	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
2018 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
2017 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
2016 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
2015 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	No
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
2014 : RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	No
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No

Form 5500 Responses for RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN

2023: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2008: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2007: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Plan funding arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2006: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2005: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Plan funding arrangement – Insurance	Yes
2005-01-01	Plan benefit arrangement – Insurance	Yes
2004: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2004 form 5500 responses
2004-01-01	Type of plan entity	Single employer plan
2004-01-01	Plan funding arrangement – Insurance	Yes
2004-01-01	Plan benefit arrangement – Insurance	Yes
2003: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2003 form 5500 responses
2003-01-01	Type of plan entity	Single employer plan
2003-01-01	Plan funding arrangement – Insurance	Yes
2003-01-01	Plan benefit arrangement – Insurance	Yes
2002: RADIOLOGY ASSOCIATES OF TALLAHASSEE CAFETERIA PLAN 2002 form 5500 responses
2002-01-01	Type of plan entity	Single employer plan
2002-01-01	Plan funding arrangement – Insurance	Yes
2002-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 184 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $13,422 Total amount of fees paid to insurance company USD $1,491 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $209,978 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	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 207 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $41,431 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $230,175 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 2 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $4,914 Health Insurance Welfare Benefit Yes 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	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 208 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $7,895 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $39,478 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )
Policy contract number	00506
Policy instance	11
Insurance contract or identification number 00506 Number of Individuals Covered 69 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $9,183 Welfare Benefit Premiums Paid to Carrier USD $502,755 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	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 94 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $4,632 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $30,879 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	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 46 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $312 Total amount of fees paid to insurance company USD $180 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,560 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0800
Policy instance	8
Insurance contract or identification number 496525 0800 Number of Individuals Covered 1 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $328 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $3,874 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )
Policy contract number	00504
Policy instance	9
Insurance contract or identification number 00504 Number of Individuals Covered 118 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $15,517 Welfare Benefit Premiums Paid to Carrier USD $844,359 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )
Policy contract number	00505
Policy instance	10
Insurance contract or identification number 00505 Number of Individuals Covered 79 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $9,328 Welfare Benefit Premiums Paid to Carrier USD $509,417 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0001
Policy instance	7
Insurance contract or identification number 496525 0001 Number of Individuals Covered 211 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $3,395 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $33,949 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0800
Policy instance	8
Insurance contract or identification number 496525 0800 Number of Individuals Covered 1 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $328 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $3,278 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $328
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0001
Policy instance	7
Insurance contract or identification number 496525 0001 Number of Individuals Covered 203 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $2,780 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $27,799 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,780
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 94 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $4,657 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $31,050 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,657
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 193 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $10,271 Total amount of fees paid to insurance company USD $5,589 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $209,219 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,070 Amount paid for insurance broker fees 5589
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 46 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $278 Total amount of fees paid to insurance company USD $180 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,387 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $278 Insurance broker organization code? 3 Amount paid for insurance broker fees 180 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 207 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $45,463 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $252,572 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $45,463
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 173 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $83,099 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $83,099 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 207 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $6,797 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $33,987 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,797 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 197 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $6,115 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $30,577 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,105 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 197 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $43,888 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $243,823 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $43,876 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 87 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $4,246 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $28,304 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,240 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0001
Policy instance	7
Insurance contract or identification number 496525 0001 Number of Individuals Covered 191 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $3,143 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $31,427 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,143
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 40 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $267 Total amount of fees paid to insurance company USD $180 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,337 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $267 Insurance broker organization code? 3 Amount paid for insurance broker fees 180 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 186 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $8,325 Total amount of fees paid to insurance company USD $7,940 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $169,385 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,162 Amount paid for insurance broker fees 7940
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0800
Policy instance	8
Insurance contract or identification number 496525 0800 Number of Individuals Covered 1 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $393 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $3,927 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $393
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 166 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $75,216 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $75,216 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 181 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $5,857 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $29,285 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,857 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0800
Policy instance	8
Insurance contract or identification number 496525 0800 Number of Individuals Covered 1 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $351 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $3,314 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $305
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 37 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of fees paid to insurance company USD $180 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,388 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 180 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES Insurance broker organization code? 3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 145 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $65,292 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $65,292 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 181 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $41,514 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $230,626 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $41,514 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 80 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $4,234 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $28,210 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,234 Insurance broker organization code? 3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 168 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $8,716 Total amount of fees paid to insurance company USD $7,320 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $177,496 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,545 Amount paid for insurance broker fees 7320
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525 0001
Policy instance	7
Insurance contract or identification number 496525 0001 Number of Individuals Covered 169 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,320 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $23,203 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,139 Insurance broker organization code? 3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 152 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $61,914 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $61,914 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 195 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $6,031 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $30,643 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,031 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 195 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $42,440 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $241,842 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $42,440 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 96 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $4,901 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $33,344 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,901 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 37 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $283 Total amount of fees paid to insurance company USD $195 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,436 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $283 Insurance broker organization code? 3 Amount paid for insurance broker fees 195 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 176 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $8,758 Total amount of fees paid to insurance company USD $7,027 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $177,810 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,586 Amount paid for insurance broker fees 7027
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	7
Insurance contract or identification number 496525 Number of Individuals Covered 157 Insurance policy start date 2018-02-01 Insurance policy end date 2019-02-01 Total amount of commissions paid to insurance broker USD $1,927 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $19,104 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,927 Insurance broker organization code? 3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 139 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $55,165 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $55,165 Insurance broker organization code? 3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 163 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $8,195 Total amount of fees paid to insurance company USD $6,808 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $166,078 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,034 Amount paid for insurance broker fees 6808
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	7
Insurance contract or identification number 496525 Number of Individuals Covered 153 Insurance policy start date 2017-02-01 Insurance policy end date 2018-02-01 Total amount of commissions paid to insurance broker USD $1,750 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $17,504 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,750 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 35 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $176 Total amount of fees paid to insurance company USD $165 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,172 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $176 Insurance broker organization code? 3 Amount paid for insurance broker fees 165 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 187 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $28,468 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $189,789 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $28,468 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 187 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $3,864 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $25,761 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,864 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 86 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $2,300 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $23,003 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,300 Insurance broker organization code? 3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000MP322
Policy instance	6
Insurance contract or identification number 000MP322 Number of Individuals Covered 159 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $7,772 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $157,328 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,620 Insurance broker name BROWN & BROWN OF FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 34 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $183 Total amount of fees paid to insurance company USD $180 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $1,222 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $183 Insurance broker organization code? 3 Amount paid for insurance broker fees 180 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES Insurance broker name MGIS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 86 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $2,592 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $25,921 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,592 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 175 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $31,327 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $208,848 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $31,327 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 175 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $4,115 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $27,430 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,115 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 136 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $53,410 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $53,410 Insurance broker organization code? 3 Insurance broker name BROWN & BROWN OF FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	7
Insurance contract or identification number 496525 Number of Individuals Covered 169 Insurance policy start date 2016-02-01 Insurance policy end date 2017-02-01 Total amount of commissions paid to insurance broker USD $1,792 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $17,923 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,792 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD236276
Policy instance	3
Insurance contract or identification number LTD236276 Number of Individuals Covered 163 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $27,452 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $183,015 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $27,452 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	7
Insurance contract or identification number 496525 Number of Individuals Covered 157 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,742 Total amount of fees paid to insurance company USD $131 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $16,260 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,742 Amount paid for insurance broker fees 131 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	000BT403
Policy instance	6
Insurance contract or identification number 000BT403 Number of Individuals Covered 146 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $6,960 Total amount of fees paid to insurance company USD $1,203 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $143,522 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,960 Amount paid for insurance broker fees 1203 Insurance broker organization code? 3 Insurance broker name BARTON FENSTERMAKER TONDELLO
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	5
Insurance contract or identification number VOL236276 Number of Individuals Covered 28 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $144 Total amount of fees paid to insurance company USD $195 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $960 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $144 Insurance broker organization code? 3 Amount paid for insurance broker fees 195 Additional information about fees paid to insurance broker ADMINISTRATIVE FEE - ALL POLICIES Insurance broker name MEDICAL GROUP INSURANCE SERVICES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	4
Insurance contract or identification number STD236276 Number of Individuals Covered 95 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $2,436 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $24,364 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,436 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	2
Insurance contract or identification number LIF236276 Number of Individuals Covered 163 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $3,435 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $22,901 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,435 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 129 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $62,887 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $62,887 Insurance broker organization code? 3 Insurance broker name BARTON, FENSTERMAKER, TONDELLO
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 125 Insurance policy start date 2014-01-01 Insurance policy end date 2014-09-30 Total amount of commissions paid to insurance broker USD $44,104 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $44,104 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	VOL236276
Policy instance	9
Insurance contract or identification number VOL236276 Number of Individuals Covered 22 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $59 Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $391 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $59 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	2
Insurance contract or identification number 00328860 Number of Individuals Covered 134 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $6,692 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $136,235 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,509 Insurance broker organization code? 3 Insurance broker name BARTON FENSTERMAKER TONDELLO
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 143 Insurance policy start date 2013-02-01 Insurance policy end date 2014-01-31 Total amount of commissions paid to insurance broker USD $1,512 Total amount of fees paid to insurance company USD $113 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $16,160 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,512 Amount paid for insurance broker fees 113 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	STD236276
Policy instance	8
Insurance contract or identification number STD236276 Number of Individuals Covered 87 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,149 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $11,488 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,149 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LIF236276
Policy instance	6
Insurance contract or identification number LIF236276 Number of Individuals Covered 158 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,616 Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $10,774 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,616 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	5
Insurance contract or identification number 90473 Number of Individuals Covered 126 Insurance policy start date 2014-10-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $14,956 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $14,956 Insurance broker organization code? 3 Insurance broker name BARTON FENSTERMAKER TONDELLO
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	LTD 236276
Policy instance	7
Insurance contract or identification number LTD 236276 Number of Individuals Covered 158 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $13,520 Total amount of fees paid to insurance company USD $90 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $90,131 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $13,520 Amount paid for insurance broker fees 90 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	4
Insurance contract or identification number 033815 Number of Individuals Covered 150 Insurance policy start date 2014-01-01 Insurance policy end date 2014-05-31 Total amount of commissions paid to insurance broker USD $10,300 Total amount of fees paid to insurance company USD $529 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $70,484 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,300 Amount paid for insurance broker fees 529 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 126 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $50,944 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $50,944 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	4
Insurance contract or identification number 033815 Insurance contract or identification number 033815 Insurance policy start date 2013-01-01 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $30,801 Total amount of commissions paid to insurance broker USD $30,801 Total amount of fees paid to insurance company USD $1,582 Total amount of fees paid to insurance company USD $1,582 Life Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $210,960 Welfare Benefit Premiums Paid to Carrier USD $210,960 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? 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 $30,801 Amount paid for insurance broker fees 1582 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	2
Insurance contract or identification number 00328860 Insurance contract or identification number 00328860 Number of Individuals Covered 132 Number of Individuals Covered 132 Insurance policy start date 2013-01-01 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $6,146 Total amount of commissions paid to insurance broker USD $6,146 Dental Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $130,405 Welfare Benefit Premiums Paid to Carrier USD $130,405 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 143 Insurance policy start date 2012-02-01 Insurance policy end date 2012-01-31 Total amount of commissions paid to insurance broker USD $1,374 Total amount of fees paid to insurance company USD $103 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $13,837 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? 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 $1,374 Amount paid for insurance broker fees 103 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	2
Insurance contract or identification number 00328860 Insurance contract or identification number 00328860 Number of Individuals Covered 132 Number of Individuals Covered 132 Insurance policy start date 2013-01-01 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $6,146 Total amount of commissions paid to insurance broker USD $6,146 Dental Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $130,405 Welfare Benefit Premiums Paid to Carrier USD $130,405 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	4
Insurance contract or identification number 496525 Number of Individuals Covered 142 Insurance policy start date 2011-02-01 Insurance policy end date 2012-01-31 Total amount of commissions paid to insurance broker USD $1,460 Total amount of fees paid to insurance company USD $176 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $14,599 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,460 Amount paid for insurance broker fees 176 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 147 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,504 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $200,530 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,504 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 123 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $49,685 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $49,685 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	2
Insurance contract or identification number 00328860 Number of Individuals Covered 132 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $5,257 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $109,186 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,257 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	4
Insurance contract or identification number 496525 Number of Individuals Covered 145 Insurance policy start date 2010-02-01 Insurance policy end date 2011-01-31 Total amount of commissions paid to insurance broker USD $1,569 Total amount of fees paid to insurance company USD $196 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $14,466 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,569 Amount paid for insurance broker fees 196 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 147 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $44,209 Total amount of fees paid to insurance company USD $3,888 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $303,351 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $44,209 Amount paid for insurance broker fees 3888 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 116 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $51,485 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $51,485 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 130 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $5,068 Total amount of fees paid to insurance company USD $1,203 Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $112,133 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,068 Amount paid for insurance broker fees 1203 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	4
Insurance contract or identification number 496525 Number of Individuals Covered 145 Insurance policy start date 2009-02-01 Insurance policy end date 2010-01-31 Total amount of commissions paid to insurance broker USD $1,423 Total amount of fees paid to insurance company USD $178 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $14,231 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,423 Amount paid for insurance broker fees 178 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 135 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $3,573 Total amount of fees paid to insurance company USD $1,203 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $104,876 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,573 Amount paid for insurance broker fees 1203 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 122 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $54,146 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $54,146 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 150 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $39,150 Total amount of fees paid to insurance company USD $3,325 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $266,027 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $39,150 Amount paid for insurance broker fees 3325 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 148 Insurance policy start date 2009-01-01 Insurance policy end date 2009-12-31 Total amount of commissions paid to insurance broker USD $3,765 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $114,468 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,719 Insurance broker organization code? 3 Insurance broker name NORTH FLORIDA FIN CORP
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 133 Insurance policy start date 2009-01-01 Insurance policy end date 2009-12-31 Total amount of commissions paid to insurance broker USD $53,657 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $53,657 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	4
Insurance contract or identification number 496525 Number of Individuals Covered 145 Insurance policy start date 2008-02-01 Insurance policy end date 2009-01-31 Total amount of commissions paid to insurance broker USD $1,607 Total amount of fees paid to insurance company USD $201 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $16,069 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 Amount paid for insurance broker fees 201 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 145 Insurance policy start date 2009-01-01 Insurance policy end date 2009-12-31 Total amount of commissions paid to insurance broker USD $43,028 Total amount of fees paid to insurance company USD $3,631 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $292,762 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $43,028 Amount paid for insurance broker fees 3631 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 142 Insurance policy start date 2008-01-01 Insurance policy end date 2008-12-31 Total amount of commissions paid to insurance broker USD $55,440 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $55,440 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 197 Insurance policy start date 2008-01-01 Insurance policy end date 2008-12-31 Total amount of commissions paid to insurance broker USD $4,764 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $123,325 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,671 Insurance broker organization code? 3 Insurance broker name NORTH FLORIDA FIN CORP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 169 Insurance policy start date 2008-01-01 Insurance policy end date 2008-12-31 Total amount of commissions paid to insurance broker USD $37,451 Total amount of fees paid to insurance company USD $4,189 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $335,080 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $37,451 Amount paid for insurance broker fees 4189 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	4
Insurance contract or identification number 496525 Number of Individuals Covered 168 Insurance policy start date 2007-02-01 Insurance policy end date 2008-01-31 Total amount of commissions paid to insurance broker USD $1,999 Total amount of fees paid to insurance company USD $250 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $19,987 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,999 Amount paid for insurance broker fees 250 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E7961741
Policy instance	5
Insurance contract or identification number E7961741 Number of Individuals Covered 50 Insurance policy start date 2006-10-01 Insurance policy end date 2007-09-30 Total amount of commissions paid to insurance broker USD $935 Total amount of fees paid to insurance company USD $121 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 $9,350 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $935 Amount paid for insurance broker fees 121 Insurance broker organization code? 3 Insurance broker name VARIOUS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E7939168
Policy instance	4
Insurance contract or identification number E7939168 Number of Individuals Covered 169 Insurance policy start date 2007-01-01 Insurance policy end date 2007-12-31 Total amount of commissions paid to insurance broker USD $25,171 Total amount of fees paid to insurance company USD $4,518 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 $251,710 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $25,171 Amount paid for insurance broker fees 4518 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 169 Insurance policy start date 2007-01-01 Insurance policy end date 2007-12-31 Total amount of commissions paid to insurance broker USD $34,388 Total amount of fees paid to insurance company USD $4,228 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $340,218 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $34,022 Amount paid for insurance broker fees 4228 Insurance broker organization code? 3 Insurance broker name NFP INSURANCE SERVICES INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 186 Insurance policy start date 2007-01-01 Insurance policy end date 2007-12-31 Total amount of commissions paid to insurance broker USD $4,790 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $121,801 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,696 Insurance broker organization code? 3 Insurance broker name NORTH FLORIDA FIN CORP
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	1
Insurance contract or identification number 90473 Number of Individuals Covered 149 Insurance policy start date 2007-01-01 Insurance policy end date 2007-12-31 Total amount of commissions paid to insurance broker USD $42,827 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $42,827 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	341972
Policy instance	1
Insurance contract or identification number 341972 Number of Individuals Covered 196 Insurance policy start date 2006-01-01 Insurance policy end date 2006-12-31 Total amount of commissions paid to insurance broker USD $22,202 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $446,966 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $22,202 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	BT658
Policy instance	2
Insurance contract or identification number BT658 Number of Individuals Covered 191 Insurance policy start date 2006-01-01 Insurance policy end date 2006-12-31 Total amount of commissions paid to insurance broker USD $4,920 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $124,174 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,822 Insurance broker organization code? 3 Insurance broker name SHAPIRO INSURANCE INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E7939168
Policy instance	4
Insurance contract or identification number E7939168 Number of Individuals Covered 169 Insurance policy start date 2006-01-01 Insurance policy end date 2006-12-31 Total amount of commissions paid to insurance broker USD $10,468 Total amount of fees paid to insurance company USD $6,691 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 $104,676 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $10,468 Amount paid for insurance broker fees 6691 Insurance broker organization code? 3 Insurance broker name VARIOUS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E7961741
Policy instance	5
Insurance contract or identification number E7961741 Number of Individuals Covered 50 Insurance policy start date 2006-01-01 Insurance policy end date 2006-09-30 Total amount of commissions paid to insurance broker USD $9,355 Total amount of fees paid to insurance company USD $6,956 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 $93,554 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $9,355 Amount paid for insurance broker fees 6956 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	6
Insurance contract or identification number 496525 Number of Individuals Covered 184 Insurance policy start date 2005-02-01 Insurance policy end date 2006-01-31 Total amount of commissions paid to insurance broker USD $2,130 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $20,040 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,115 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FL
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	3
Insurance contract or identification number 033815 Number of Individuals Covered 184 Insurance policy start date 2006-02-01 Insurance policy end date 2006-12-31 Total amount of commissions paid to insurance broker USD $29,263 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $307,781 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $29,263 Insurance broker organization code? 3 Insurance broker name FINANCIAL PARTNERS OF NORTH FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	1
Insurance contract or identification number 00328860 Number of Individuals Covered 188 Insurance policy start date 2005-01-01 Insurance policy end date 2005-12-31 Total amount of commissions paid to insurance broker USD $5,778 Total amount of fees paid to insurance company USD $4,926 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $131,904 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $113 Insurance broker organization code? 3 Amount paid for insurance broker fees 4926 Insurance broker name SHAPIRO INSURANCE INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	501712
Policy instance	2
Insurance contract or identification number 501712 Number of Individuals Covered 182 Insurance policy start date 2005-01-01 Insurance policy end date 2005-12-31 Total amount of commissions paid to insurance broker USD $2,629 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $27,359 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $930 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 176 Insurance policy start date 2004-02-01 Insurance policy end date 2005-01-31 Total amount of commissions paid to insurance broker USD $1,494 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $20,058 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,494 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	4
Insurance contract or identification number 90473 Number of Individuals Covered 62 Insurance policy start date 2005-01-01 Insurance policy end date 2005-12-31 Total amount of commissions paid to insurance broker USD $25,895 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $25,895 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	33815
Policy instance	6
Insurance contract or identification number 33815 Number of Individuals Covered 182 Insurance policy start date 2005-01-01 Insurance policy end date 2005-12-31 Total amount of commissions paid to insurance broker USD $7,285 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $328,530 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $7,285 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	033815
Policy instance	7
Insurance contract or identification number 033815 Number of Individuals Covered 174 Insurance policy start date 2004-07-01 Insurance policy end date 2005-06-30 Total amount of commissions paid to insurance broker USD $6,674 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $331,251 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,337 Insurance broker organization code? 3 Insurance broker name GILES TOOLE JR
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	501712
Policy instance	2
Insurance contract or identification number 501712 Number of Individuals Covered 174 Insurance policy start date 2004-01-01 Insurance policy end date 2004-12-31 Total amount of commissions paid to insurance broker USD $2,258 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $29,458 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,258 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	1
Insurance contract or identification number 00328860 Number of Individuals Covered 180 Insurance policy start date 2004-01-01 Insurance policy end date 2004-12-31 Total amount of commissions paid to insurance broker USD $5,534 Total amount of fees paid to insurance company USD $4,800 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $124,116 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,534 Amount paid for insurance broker fees 4800 Insurance broker organization code? 3 Insurance broker name SHAPIRO INSURANCE INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	4
Insurance contract or identification number 90473 Number of Individuals Covered 62 Insurance policy start date 2004-01-01 Insurance policy end date 2004-12-31 Total amount of commissions paid to insurance broker USD $24,323 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $24,323 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 176 Insurance policy start date 2003-02-01 Insurance policy end date 2004-01-31 Total amount of commissions paid to insurance broker USD $1,339 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $8,928 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,339 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	4
Insurance contract or identification number 90473 Number of Individuals Covered 62 Insurance policy start date 2003-01-01 Insurance policy end date 2003-12-31 Total amount of commissions paid to insurance broker USD $22,583 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $22,583 Insurance broker organization code? 3 Insurance broker name VARIOUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 176 Insurance policy start date 2002-02-01 Insurance policy end date 2003-01-31 Total amount of commissions paid to insurance broker USD $1,195 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $7,969 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,195 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	501712
Policy instance	2
Insurance contract or identification number 501712 Number of Individuals Covered 174 Insurance policy start date 2003-01-01 Insurance policy end date 2003-12-31 Total amount of commissions paid to insurance broker USD $2,116 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $18,669 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,116 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	1
Insurance contract or identification number 00328860 Number of Individuals Covered 173 Insurance policy start date 2003-01-01 Insurance policy end date 2003-12-31 Total amount of commissions paid to insurance broker USD $5,299 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $117,509 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,299 Insurance broker organization code? 3 Insurance broker name SHAPIRO INSURANCE INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00328860
Policy instance	1
Insurance contract or identification number 00328860 Number of Individuals Covered 162 Insurance policy start date 2002-01-01 Insurance policy end date 2002-12-31 Total amount of commissions paid to insurance broker USD $5,095 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $106,305 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,095 Insurance broker organization code? 3 Insurance broker name SHAPIRO INSURANCE INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	501712
Policy instance	2
Insurance contract or identification number 501712 Number of Individuals Covered 174 Insurance policy start date 2002-01-01 Insurance policy end date 2002-12-31 Total amount of commissions paid to insurance broker USD $1,878 Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $16,195 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,878 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	496525
Policy instance	3
Insurance contract or identification number 496525 Number of Individuals Covered 162 Insurance policy start date 2001-02-01 Insurance policy end date 2002-01-31 Total amount of commissions paid to insurance broker USD $1,195 Other welfare benefits provided GROUP LONG TERM CARE Welfare Benefit Premiums Paid to Carrier USD $7,969 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $1,195 Insurance broker organization code? 3 Insurance broker name JOHN S OLSON CLU INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	90473
Policy instance	4
Insurance contract or identification number 90473 Number of Individuals Covered 62 Insurance policy start date 2002-01-01 Insurance policy end date 2002-12-31 Total amount of commissions paid to insurance broker USD $20,686 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $20,686 Insurance broker organization code? 3 Insurance broker name VARIOUS

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• RADIOLOGY ASSOCIATES OF ROANOKE 401(K)PROFIT SHARING PLAN [EIN = 540851534]
• RADIOLOGY ASSOCIATES OF NORTH TEXAS, P.A. SAVINGS AND INVESTMENT PLAN [EIN = 751286819]
• RADIOLOGY ASSOCIATES, P.A. PROFIT SHARING PLAN [EIN = 710395194]
• RADIOLOGY ASSOCIATES OF CLEARWATER PROFIT SHARING PLAN AND TRUST [EIN = 591212948]
• RADIOLOGY ASSOCIATES OF ALBUQUERQUE , P.A. 401(K) RETIREMENT PLAN [EIN = 850214117]
• RADIOLOGY ASSOCIATES OF THE FOX VALLEY, S.C. CASH BALANCE PLAN [EIN = 390867579]
• RADIOLOGY ASSOCIATES, INC. DEFINED BENEFIT PLAN [EIN = 990144047]
• RADIOLOGY ASSOCIATES OF NORTH ALABAMA, P.C. 401(K) PROFIT SHARING PLAN [EIN = 630620807]
• RADIOLOGY ASSOCIATES OF HARTFORD, PC 401(K) PLAN [EIN = 060935472]
• RADIOLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN [EIN = 351153879]
• RADIOLOGY ASSOCIATES OF NATCHEZ, P.A. PROFIT SHARING PLAN [EIN = 640620495]
• RADIOLOGY ASSOCIATES, INC. 401(K) RETIREMENT SAVINGS PLAN (001) [EIN = 990144047]
• RADIOLOGY ASSOCIATES OF WYOMING VALLEY, INC. RETIREMENT PLAN [EIN = 200114570]
• RADIOLOGY ASSOCIATES OF VALDOSTA, LLC 401 K PLAN [EIN = 273801307]
• RADIOLOGY ASSOCIATES OF THE FOX VALLEY, S.C. EMPLOYEES PROFIT SHARING AND 401(K) PLAN [EIN = 390867579]
• RADIOLOGY ASSOCIATES OF MILWAUKEE, S.C. 401K PROFIT SHARING PLAN [EIN = 391130016]
• RADIOLOGY ASSOCIATES OF ABILENE, PA 401(K) PROFIT SHARING PLAN & TRUST [EIN = 751292603]
• RADIOLOGY ASSOCIATES OF FLORIDA, LLC 401(K) PLAN [EIN = 472028856]
• RADIOLOGY ASSOCIATES OF NORWOOD, INC. 401(K) PROFIT SHARING PLAN [EIN = 042472467]
• RADIOLOGY ASSOCIATES, PC 401(K) PROFIT SHARING PLAN [EIN = 620812834]
• RADIOLOGY ASSOCIATES, INC. CASH BALANCE PLAN [EIN = 550521440]
• RADIOLOGY ASSOCIATES OF ITHACA, P.C. EMPLOYEES' DEFINED BENEFIT PENSION PLAN [EIN = 161147123]
• RADIOLOGY ASSOCIATES, INC. CASH BALANCE PLAN [EIN = 550521440]
• RADIOLOGY ASSOCIATES OF PLYMOUTH, INC. PROFIT SHARING PLAN [EIN = 042461204]
• RADIOLOGY ASSOCIATES OF ST. PETERSBURG, P.A. RETIREMENT PLAN [EIN = 591316491]
• RADIOLOGY ASSOCIATES OF IBERIA 401K PLAN [EIN = 720898873]
• RADIOLOGY ASSOCIATES OF VENICE AND ENGLEWOOD, P.A. PROFIT SHARING PLAN [EIN = 591937565]
• RADIOLOGY ASSOCIATES 401 K PROFIT SHARING PLAN TRUST [EIN = 221908418]
• RADIOLOGY ASSOCIATES SEO, INC. CASH BALANCE PENSION PLAN AND TRUST [EIN = 481290229]
• RADIOLOGY ASSOCIATES,INC 401K PROFIT SHARING PLAN [EIN = 550521440]
• RADIOLOGY ASSOCIATES OF THE TREASURE COAST RETIREMENT PLAN [EIN = 010574210]
• RADIOLOGY ASSOCIATES OF BERRIEN COUNTY, P.C. PROFIT SHARING PLAN [EIN = 381897758]
• RADIOLOGY ASSOCIATES OF BROOKLYN, LLP 401(K) PLAN [EIN = 112523946]
• RADIOLOGY ASSOCIATES OF DUBLIN LLC 401K PLAN [EIN = 204527769]
• RADIOLOGY ASSOCIATES OF MANSFIELD, INC. CASH BALANCE PLAN [EIN = 341109510]
• RADIOLOGY ASSOCIATES OF ALBANY, P.A. PROFIT SHARING PLAN & TRUST [EIN = 581079335]
• RADIOLOGY ASSOCIATES, PROF L.L.C. 401(K) PROFIT SHARING PLAN [EIN = 460226963]
• RADIOLOGY ASSOCIATES 401K PROFIT SHARING PLAN [EIN = 570518181]
• RADIOLOGY ASSOCIATES OF WAUSAU, S.C. DEFINED BENEFIT PLAN [EIN = 391203125]
• RADIOLOGY ASSOCIATES OF COLUMBUS, P.C. CASH BALANCE PENSION PLAN [EIN = 581048965]
• RADIOLOGY ASSOCIATES EMPLOYEES PROFIT SHARING PLAN [EIN = 591941740]
• RADIOLOGY ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PLAN [EIN = 593396677]
• RADIOLOGY ASSOCIATES LLC PROFIT SH PL AND TR [EIN = 720891412]
• RADIOLOGY ASSOCIATES, P.C. EMPLOYEE SAVINGS PLAN [EIN = 930593725]
• RADIOLOGY ASSOCIATES OF ROCKLEDGE, LLP 401K PLAN AND TRUST [EIN = 591970937]
• RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA, PMC CASH BALANCE PLAN [EIN = 741740101]
• RADIOLOGY ASSOCIATES OF HOUSTON CO., PA 401K PROFIT SHARING PLAN & TRUST [EIN = 581090888]
• RADIOLOGY ASSOCIATES OF KEENE, P.C. PROFIT SHARING PLAN [EIN = 020361503]
• RADIOLOGY ASSOCIATES, P.A. EMPLOYEES' RETIREMENT PLAN [EIN = 640500568]
• RADIOLOGY ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN [EIN = 470781808]
• RADIOLOGY ASSOCIATES OF ENID, P. C. PROFIT SHARING PLAN [EIN = 731345163]
• RADIOLOGY ASSOCIATES, INC. PROFIT SHARING PLAN [EIN = 990144047]
• RADIOLOGY ASSOCIATES OF MUNCIE, INC. 401(K) PLAN [EIN = 351389240]
• RADIOLOGY ASSOCIATES OF BROOKLYN, LLP 401(K) PLAN [EIN = 113190147]
• RADIOLOGY ASSOCIATES OF FORT LAUDERDALE PROFIT SHARING PLAN [EIN = 591562872]
• RADIOLOGY ASSOCIATES OF MOBILE, P.C. CASH BALANCE PLAN [EIN = 630572355]
• RADIOLOGY ASSOCIATES OF WAUSAU, S.C. 401(K) PROFIT SHARING PLAN [EIN = 391203125]
• RADIOLOGY ASSOCIATES OF LEWIS COUNTY, INC. 401(K) PLAN [EIN = 911433361]
• RADIOLOGY ASSOCIATES OF OTTUMWA PROFIT SHARING 401 (K) PLAN [EIN = 421085912]
• RADIOLOGY ASSOCIATES OF ITHACA, P.C. EMPLOYEES' DEFERRED SAVINGS AND PSP [EIN = 161147123]
• RADIOLOGY ASSOCIATES OF INDIANAPOLIS, INC CASH BALANCE PLAN [EIN = 351187380]
• RADIOLOGY ASSOCIATES OF ALABAMA PC RETIREMENT PLAN [EIN = 631247115]
• RADIOLOGY ASSOCIATES OF MANSFIELD, INC. 401(K) PROFIT SHARING TRUST [EIN = 341109510]
• RADIOLOGY ASSOCIATES OF MURRAY PLLC EMPLOYEE PROFIT SHARING TRUST [EIN = 621505826]
• RADIOLOGY ASSOCIATES OF DUBLIN LLC 401K PLAN [EIN = 266034878]
• RADIOLOGY ASSOCIATES OF LONGWOOD AVENUE, P.C. PROFIT SHARING PLAN [EIN = 043296479]
• RADIOLOGY ASSOCIATES SEO, INC. 401(K) PLAN [EIN = 481290229]
• RADIOLOGY ASSOCIATES OF POUGHKEEPSIE, PLLC INCENTIVE SAVINGS TRUST [EIN = 141811465]
• RADIOLOGY ASSOCIATES OF NEW JERSEY, P.C. 401(K) PROFIT SHARING PLAN [EIN = 202226053]
• RADIOLOGY ASSOCIATES OF VALDOSTA, P.C. 401 K PLAN [EIN = 581026264]
• RADIOLOGY ASSOCIATES OF BEAVER DAM, COLUMBUS & WAUPUN, LTD. PROFIT SHARING PLAN [EIN = 391232015]
• RADIOLOGY ASSOCIATES OF MILWAUKEE, S.C. CASH BALANCE PLAN [EIN = 391130016]
• RADIOLOGY ASSOCIATES OF FLORIDA, LLC CASH BALANCE PLAN [EIN = 472028856]
• RADIOLOGY ASSOCIATES OF VALDOSTA, P.C. MONEY PURCHASE PENSION PLAN [EIN = 581026264]
• RADIOLOGY ASSOCIATES PA OF FORT LAUDERDALE DEFINED BENEFIT PENSION TRUST [EIN = 591562872]
• RADIOLOGY ASSOCIATES OF THE DESERT, AMC PROFIT SHARING PLAN [EIN = 330946095]
• RADIOLOGY ASSOCIATES OF SAN ANTONIO, P.A. EMPLOYEES' PROFIT SHARING PLAN AND TRUST [EIN = 741405282]
• RADIOLOGY ASSOCIATES OF MOULTRIE GEORGIA, P.C. PROFIT SHARING PLAN [EIN = 581221092]
• RADIOLOGY ASSOCIATES OF CENTRAL FLORIDA, P.L. 401(K) PLAN AND TRUST [EIN = 593635297]
• RADIOLOGY ASSOCIATES OF RICHMOND LTD [EIN = 540888075]
• RADIOLOGY ASSOCIATES OF HOLLYWOOD FLEXIBLE BENEFITS PLAN [EIN = 651075205]
• RADIOLOGY ASSOCIATES, P.A. HEALTH PLAN [EIN = 710395194]
• RADIOLOGY ASSOCIATES, P.A. LIFE, LTD AND AD&D PLAN [EIN = 710395194]
• RADIOLOGY ASSOCIATES, P.A. DENTAL PLAN [EIN = 710395194]
• RADIOLOGY ASSOCIATES, P.A. VISION PLAN [EIN = 710395194]
• RADIOLOGY ASSOCIATES OF MACON, PC 401(K) PROFIT SHARING PLAN [EIN = 581126891]
• RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO 401(K) PROFIT SHARING PLAN [EIN = 770447321]
• RADIOLOGY ASSOCIATES LLC 401K PLAN [EIN = 201209403]
• RADIOLOGY ASSOCIATES OF TAMPA, P. A. RETIREMENT PLAN AND TRUST [EIN = 593740614]
• RADIOLOGY ASSOCIATES OF WESTERN PA PROFIT SHARING [EIN = 251605156]
• RADIOLOGY ASSOCIATES OF MIAMI BEACH PROFIT SHARING PLAN [EIN = 650994853]
• RADIOLOGY ASSOCIATES OF OXFORD P.A. DEFINED BENEFIT PLAN [EIN = 640602163]
• RADIOLOGY ASSOCIATES OF SOUTHERN ILLINOIS, P.C. 401K PROFIT SHARING PLAN [EIN = 900061783]
• RADIOLOGY ASSOCIATES, INC. PROFIT SHARING PLAN (PREVIOUSLY KNWON AS RADIOLOGY ASSOCIATES, INC. EMPLOYEE STOCK OWNERSHIP PLAN) [EIN = 510103905]
• RADIOLOGY ASSOCIATES, PA GCF BENEFIT PLAN [EIN = 581079335]
• RADIOLOGY ASSOCIATES OF NORTH TEXAS, P.A. CASH BALANCE PENSION PLAN [EIN = 751286819]
• RADIOLOGY ASSOCIATES OF WAUSAU, S.C. CASH BALANCE PLAN [EIN = 391203125]
• RADIOLOGY ASSOCIATES OF MOBILE, P.C. CASH BALANCE PLAN 2 [EIN = 630572355]
• RADIOLOGY ASSOCIATES, P. C. CASH BALANCE PLAN [EIN = 930593725]
• RADIOLOGY ASSOCIATES OF DEKALB PC GCF BENEFIT PLAN [EIN = 581304565]
• RADIOLOGY ASSOCIATES OF RICHMOND HEALTH PLAN [EIN = 540888075]
• RADIOLOGY ASSOCIATES OF RICHMOND, INC. EMPLOYEE BENEFIT PLAN [EIN = 540888075]
• RADIOLOGY ASSOCIATES, INC. CASH BALANCE PLAN [EIN = 351153879]
• RADIOLOGY ASSOCIATES OF MARYLAND, LLC 401(K) PROFIT SHARING PLAN [EIN = 473934112]
• RADIOLOGY ASSOCIATES, PC HEALTH AND WELFARE PLAN [EIN = 470781808]
• RADIOLOGY ASSOCIATES OF BIRMINGHAM, P.C. CASH BALANCE PLAN [EIN = 630574300]
• RADIOLOGY ASSOCIATES OF VALDOSTA, LLC GCF BENEFIT PLAN [EIN = 273801307]
• RADIOLOGY ASSOCIATES CASH BALANCE PLAN [EIN = 610679378]
• RADIOLOGY ASSOCIATES OF ATLANTA, P.C. CASH BALANCE PLAN [EIN = 581075840]
• RADIOLOGY ASSOCIATES OF MOULTRIE, GEORGIA, P.C. 401(K) PROFIT SHARING PLAN [EIN = 821428268]
• RADIOLOGY ASSOCIATES OF ST. PETERSBURG, P. A. RETIREMENT PLAN [EIN = 591316491]
• RADIOLOGY ASSOCIATES OF RICHMOND CAPTIVE HEALTH PLAN [EIN = 540888075]