COOKS PEST CONTROL CO., INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC.
401k plan membership statisitcs for GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC.
| Measure | Date | Value |
|---|
| 2023: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 1,541 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 1,543 |
| 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 | 1,543 |
| 2022: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 1,655 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,541 |
| 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 | 1,541 |
| 2021: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,655 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1,655 |
| 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 | 1,655 |
| 2020: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,658 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,655 |
| 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 | 1,655 |
| 2019: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,625 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,658 |
| 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 | 1,658 |
| 2018: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,532 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,603 |
| 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 | 1,603 |
| 2017: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,532 |
| 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 | 1,532 |
| 2016: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,316 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,433 |
| 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 | 1,433 |
| 2015: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 1,031 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,316 |
| 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 | 1,316 |
| 2014: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 976 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,031 |
| 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 | 1,031 |
| 2013: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 984 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 976 |
| Total of all active and inactive participants | 2013-01-01 | 976 |
| 2012: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 980 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 984 |
| Total of all active and inactive participants | 2012-01-01 | 984 |
| 2011: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 974 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 980 |
| Total of all active and inactive participants | 2011-01-01 | 980 |
| 2009: GROUP INSURANCE PLAN FOR EMPLOYEES OF COOK'S PEST CONTROL, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 985 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 985 |
| Total of all active and inactive participants | 2009-01-01 | 985 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $3,293 | | Total amount of fees paid to insurance company | USD $625 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1192 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $13,520 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $135,087 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 584 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $10,077 | | Total amount of fees paid to insurance company | USD $1,823 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $100,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1543 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $517 | | Total amount of fees paid to insurance company | USD $99 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $5,172 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1455 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $29,005 | | Total amount of fees paid to insurance company | USD $5,472 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $290,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1543 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $43,475 | | Total amount of fees paid to insurance company | USD $5,812 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $289,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1541 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $290,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1465 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $273,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1541 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $4,942 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 533 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $91,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1185 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $132,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1655 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $291,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1577 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $237,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1655 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $6,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 503 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1185 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $141,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1655 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $43,339 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $288,929 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,339 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1577 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $23,542 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $235,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,542 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1655 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $485 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $4,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $485 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 503 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,891 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,891 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1185 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $13,974 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $139,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,974 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,598 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,976 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,598 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1658 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $53,492 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $356,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,492 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1546 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $29,901 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $299,011 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,901 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $6,639 | | Total amount of fees paid to insurance company | USD $233 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,387 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,639 | | Amount paid for insurance broker fees | 233 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1623 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $594 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $5,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $594 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1201 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $13,456 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $146,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,456 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,159 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,159 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $2,640 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,640 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1120 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $13,543 | | Are there contracts with allocated funds for individual policies? | 1 | | Contracts With Unallocated Funds Deposit Administration | 1 | | Vision 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 $13,543 | | Insurance broker organization code? | 3 |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $3,106 | | Total amount of fees paid to insurance company | USD $1,300 | | Are there contracts with allocated funds for individual policies? | 1 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,065 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,106 | | Amount paid for insurance broker fees | 1300 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1603 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $523 | | Are there contracts with allocated funds for individual policies? | 1 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $523 |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1527 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $24,586 | | Are there contracts with allocated funds for individual policies? | 1 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $245,856 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,586 |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1532 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $51,897 | | Are there contracts with allocated funds for individual policies? | 1 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,897 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30056485 |
| Policy instance | 5 |
| Insurance contract or identification number | 30056485 | | Number of Individuals Covered | 1120 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $13,543 | | Are there contracts with allocated funds for individual policies? | 1 | | Contracts With Unallocated Funds Deposit Administration | 1 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,543 | | Insurance broker organization code? | 3 | | Insurance broker name | J SMITH LANIER, INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VPL302285 |
| Policy instance | 4 |
| Insurance contract or identification number | VPL302285 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,601 | | Are there contracts with allocated funds for individual policies? | 1 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,007 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,601 | | Insurance broker name | J SMITH LANIER & CO |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1532 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $469 | | Are there contracts with allocated funds for individual policies? | 1 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $469 | | Insurance broker name | J SMITH LANIER & CO |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1532 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $18,749 | | Are there contracts with allocated funds for individual policies? | 1 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $187,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,749 | | Insurance broker name | J SMITH LANIER & CO |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1532 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $46,225 | | Are there contracts with allocated funds for individual policies? | 1 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $308,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,225 | | Insurance broker organization code? | 3 | | Insurance broker name | J SMITH LANIER & CO |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1316 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $46,021 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $283,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,021 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1316 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $14,208 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,090 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,208 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1316 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $490 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,519 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $490 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93340 ) |
| Policy contract number | 403662 |
| Policy instance | 5 |
| Insurance contract or identification number | 403662 | | Number of Individuals Covered | 1071 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $24,290 | | Welfare Benefit Premiums Paid to Carrier | USD $269,887 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,290 | | Insurance broker organization code? | 3 | | Insurance broker name | |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $2,704 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,942 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,704 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1270 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $47,991 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $288,141 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,991 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1270 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $12,610 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,101 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,610 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1270 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $435 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $435 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $2,362 | | Long Term Disability 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 $2,362 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93340 ) |
| Policy contract number | 403662 |
| Policy instance | 5 |
| Insurance contract or identification number | 403662 | | Number of Individuals Covered | 1042 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $22,538 | | Welfare Benefit Premiums Paid to Carrier | USD $250,420 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,538 | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93340 ) |
| Policy contract number | 403662 |
| Policy instance | 5 |
| Insurance contract or identification number | 403662 | | Number of Individuals Covered | 994 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $22,313 | | Welfare Benefit Premiums Paid to Carrier | USD $247,921 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,313 | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $2,201 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,201 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1258 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $419 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $419 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1258 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $12,103 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,030 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,103 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1258 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $28,949 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $289,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,949 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93340 ) |
| Policy contract number | 403662 |
| Policy instance | 5 |
| Insurance contract or identification number | 403662 | | Number of Individuals Covered | 984 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $22,678 | | Welfare Benefit Premiums Paid to Carrier | USD $226,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,678 | | Insurance broker organization code? | 3 | | Insurance broker name | |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $2,190 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,675 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,190 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1234 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $413 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $413 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1229 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $29,868 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $292,548 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,868 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 2 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1234 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $12,051 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $123,213 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,051 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | 1003567000 |
| Policy instance | 3 |
| Insurance contract or identification number | 1003567000 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $31,925 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $630,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1189 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $40,227 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $309,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AD3S |
| Policy instance | 2 |
| Insurance contract or identification number | G000AD3S | | Number of Individuals Covered | 918 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-06-01 | | Total amount of commissions paid to insurance broker | USD $21,285 | | Welfare Benefit Premiums Paid to Carrier | USD $177,374 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 4 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1189 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $13,506 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $135,065 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 5 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1189 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $409 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD118211 |
| Policy instance | 6 |
| Insurance contract or identification number | LTD118211 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $2,751 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AD3S |
| Policy instance | 2 |
| Insurance contract or identification number | G000AD3S | | Number of Individuals Covered | 898 | | Insurance policy start date | 2009-06-01 | | Insurance policy end date | 2010-06-01 | | Total amount of commissions paid to insurance broker | USD $18,476 | | Welfare Benefit Premiums Paid to Carrier | USD $153,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,476 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | J. SMITH LANIER & COMPANY |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | 1003567000 |
| Policy instance | 3 |
| Insurance contract or identification number | 1003567000 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2009-04-01 | | Insurance policy end date | 2010-03-31 | | Total amount of commissions paid to insurance broker | USD $29,787 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $609,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,787 | | Insurance broker organization code? | 3 | | Insurance broker name | NORTHWESTERN BENEFIT CORPORATION |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | G159736 |
| Policy instance | 4 |
| Insurance contract or identification number | G159736 | | Number of Individuals Covered | 1209 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Total amount of commissions paid to insurance broker | USD $13,425 | | Total amount of fees paid to insurance company | USD $4,269 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $134,225 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,425 | | Amount paid for insurance broker fees | 4269 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR204333 |
| Policy instance | 5 |
| Insurance contract or identification number | VAR204333 | | Number of Individuals Covered | 1209 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Total amount of commissions paid to insurance broker | USD $405 | | Total amount of fees paid to insurance company | USD $129 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $405 | | Amount paid for insurance broker fees | 129 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL144391 |
| Policy instance | 1 |
| Insurance contract or identification number | GL144391 | | Number of Individuals Covered | 1209 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Total amount of commissions paid to insurance broker | USD $40,755 | | Total amount of fees paid to insurance company | USD $9,527 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $313,501 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,755 | | Amount paid for insurance broker fees | 9527 | | Insurance broker organization code? | 3 | | Insurance broker name | THE WENZLER AGENCY |
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