LULA-WESTFIELD, L.L.C. has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022: LONG TERM DISABILITY D 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-06-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 186 |
| Total of all active and inactive participants | 2022-06-01 | 186 |
| Total participants, beginning-of-year | 2022-03-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 91 |
| Total of all active and inactive participants | 2022-03-01 | 91 |
| 2021: LONG TERM DISABILITY D 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-06-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 192 |
| Total of all active and inactive participants | 2021-06-01 | 192 |
| Total participants, beginning-of-year | 2021-03-01 | 94 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 93 |
| Total of all active and inactive participants | 2021-03-01 | 93 |
| 2020: LONG TERM DISABILITY D 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 214 |
| Total of all active and inactive participants | 2020-06-01 | 214 |
| Total participants, beginning-of-year | 2020-03-01 | 93 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 94 |
| Total of all active and inactive participants | 2020-03-01 | 94 |
| 2019: LONG TERM DISABILITY D 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 214 |
| Total of all active and inactive participants | 2019-06-01 | 214 |
| Total participants, beginning-of-year | 2019-03-01 | 87 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 93 |
| Total of all active and inactive participants | 2019-03-01 | 93 |
| 2018: LONG TERM DISABILITY D 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 218 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 201 |
| Total of all active and inactive participants | 2018-06-01 | 201 |
| Total participants, beginning-of-year | 2018-03-01 | 85 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 87 |
| Total of all active and inactive participants | 2018-03-01 | 87 |
| 2017: LONG TERM DISABILITY D 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 216 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 218 |
| Total of all active and inactive participants | 2017-06-01 | 218 |
| Total participants, beginning-of-year | 2017-03-01 | 87 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 85 |
| Total of all active and inactive participants | 2017-03-01 | 85 |
| 2016: LONG TERM DISABILITY D 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 216 |
| Total of all active and inactive participants | 2016-06-01 | 216 |
| Total participants, beginning-of-year | 2016-03-01 | 90 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 87 |
| Total of all active and inactive participants | 2016-03-01 | 87 |
| 2015: LONG TERM DISABILITY D 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 202 |
| Total of all active and inactive participants | 2015-06-01 | 202 |
| Total participants, beginning-of-year | 2015-03-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 90 |
| Total of all active and inactive participants | 2015-03-01 | 90 |
| 2014: LONG TERM DISABILITY D 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 209 |
| Total of all active and inactive participants | 2014-06-01 | 209 |
| Total participants, beginning-of-year | 2014-03-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 95 |
| Total of all active and inactive participants | 2014-03-01 | 95 |
| 2013: LONG TERM DISABILITY D 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 209 |
| Total of all active and inactive participants | 2013-06-01 | 209 |
| Total participants, beginning-of-year | 2013-03-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 96 |
| Total of all active and inactive participants | 2013-03-01 | 96 |
| 2012: LONG TERM DISABILITY D 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 206 |
| Total of all active and inactive participants | 2012-06-01 | 206 |
| Total participants, beginning-of-year | 2012-03-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 102 |
| Total of all active and inactive participants | 2012-03-01 | 102 |
| 2011: LONG TERM DISABILITY D 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 197 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 194 |
| Total of all active and inactive participants | 2011-06-01 | 194 |
| Total participants, beginning-of-year | 2011-03-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 101 |
| Total of all active and inactive participants | 2011-03-01 | 101 |
| 2010: LONG TERM DISABILITY D 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 103 |
| Total of all active and inactive participants | 2010-03-01 | 103 |
| 2009: LONG TERM DISABILITY D 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 109 |
| Total of all active and inactive participants | 2009-06-01 | 109 |
| Total participants, beginning-of-year | 2009-03-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 114 |
| Total of all active and inactive participants | 2009-03-01 | 114 |
| 2022: LONG TERM DISABILITY D 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-03-01 | Type of plan entity | Single employer plan |
| 2022-03-01 | Plan funding arrangement – Insurance | Yes |
| 2022-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: LONG TERM DISABILITY D 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-03-01 | Type of plan entity | Single employer plan |
| 2021-03-01 | Plan funding arrangement – Insurance | Yes |
| 2021-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: LONG TERM DISABILITY D 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | Plan funding arrangement – Insurance | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: LONG TERM DISABILITY D 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: LONG TERM DISABILITY D 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: LONG TERM DISABILITY D 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: LONG TERM DISABILITY D 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: LONG TERM DISABILITY D 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: LONG TERM DISABILITY D 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: LONG TERM DISABILITY D 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: LONG TERM DISABILITY D 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LONG TERM DISABILITY D 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: LONG TERM DISABILITY D 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: LONG TERM DISABILITY D 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | Submission has been amended | Yes |
| 2009-06-01 | This submission is the final filing | No |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 186 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-06-01 | | Total amount of commissions paid to insurance broker | USD $38,074 | | Total amount of fees paid to insurance company | USD $20,754 | | 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 $38,074 | | Amount paid for insurance broker fees | 20754 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 91 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-03-01 | | Total amount of commissions paid to insurance broker | USD $6,301 | | Total amount of fees paid to insurance company | USD $1,626 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,503 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,301 | | Amount paid for insurance broker fees | 1626 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 192 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-06-01 | | Total amount of commissions paid to insurance broker | USD $34,482 | | Total amount of fees paid to insurance company | USD $20,500 | | 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 $34,482 | | Amount paid for insurance broker fees | 20500 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 93 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-03-01 | | Total amount of commissions paid to insurance broker | USD $6,345 | | Total amount of fees paid to insurance company | USD $1,904 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,724 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,345 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1904 |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 214 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-06-01 | | Total amount of commissions paid to insurance broker | USD $33,329 | | Total amount of fees paid to insurance company | USD $19,060 | | 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 $33,329 | | Amount paid for insurance broker fees | 19060 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 94 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-03-01 | | Total amount of commissions paid to insurance broker | USD $6,296 | | Total amount of fees paid to insurance company | USD $2,006 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,296 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2006 |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 214 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-06-01 | | Total amount of commissions paid to insurance broker | USD $29,315 | | Total amount of fees paid to insurance company | USD $18,364 | | 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 $29,315 | | Amount paid for insurance broker fees | 18364 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 93 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-03-01 | | Total amount of commissions paid to insurance broker | USD $6,113 | | Total amount of fees paid to insurance company | USD $1,186 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,113 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1186 |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $124 | | Total amount of fees paid to insurance company | USD $146 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $7,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $124 | | Amount paid for insurance broker fees | 146 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 201 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-06-01 | | Total amount of commissions paid to insurance broker | USD $29,154 | | Total amount of fees paid to insurance company | USD $21,763 | | 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 $29,154 | | Amount paid for insurance broker fees | 21763 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 87 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-03-01 | | Total amount of commissions paid to insurance broker | USD $5,949 | | Total amount of fees paid to insurance company | USD $433 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,949 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 433 |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $683 | | Total amount of fees paid to insurance company | USD $98 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $7,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $683 | | Amount paid for insurance broker fees | 98 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 218 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-06-01 | | Total amount of commissions paid to insurance broker | USD $31,541 | | Total amount of fees paid to insurance company | USD $20,167 | | 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 $31,541 | | Amount paid for insurance broker fees | 20167 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 85 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-03-01 | | Total amount of commissions paid to insurance broker | USD $5,760 | | Total amount of fees paid to insurance company | USD $1,154 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,799 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,760 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1154 | | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 202 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-06-01 | | Total amount of commissions paid to insurance broker | USD $29,266 | | Total amount of fees paid to insurance company | USD $18,639 | | 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 $29,266 | | Amount paid for insurance broker fees | 18639 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-06-01 | | Total amount of commissions paid to insurance broker | USD $644 | | Total amount of fees paid to insurance company | USD $253 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $644 | | Amount paid for insurance broker fees | 253 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 90 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-03-01 | | Total amount of commissions paid to insurance broker | USD $5,316 | | Total amount of fees paid to insurance company | USD $1,050 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,580 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,316 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1050 | | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-06-01 | | Total amount of commissions paid to insurance broker | USD $620 | | Total amount of fees paid to insurance company | USD $186 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $620 | | Amount paid for insurance broker fees | 186 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-06-01 | | Total amount of commissions paid to insurance broker | USD $39,281 | | Total amount of fees paid to insurance company | USD $18,602 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $39,281 | | Amount paid for insurance broker fees | 18602 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES BATON RO |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 95 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $5,255 | | Total amount of fees paid to insurance company | USD $1,336 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,255 | | Amount paid for insurance broker fees | 1336 | | Insurance broker organization code? | 3 | | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 209 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-06-01 | | Total amount of commissions paid to insurance broker | USD $40,411 | | Total amount of fees paid to insurance company | USD $18,493 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $36,938 | | Amount paid for insurance broker fees | 5006 | | Additional information about fees paid to insurance broker | BONUS AND INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTEGRATED INSURA |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 119 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-06-01 | | Total amount of commissions paid to insurance broker | USD $633 | | Total amount of fees paid to insurance company | USD $141 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,623 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $573 | | Amount paid for insurance broker fees | 96 | | Additional information about fees paid to insurance broker | BONUS AND INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTERGRATED INSURA |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 96 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $5,339 | | Total amount of fees paid to insurance company | USD $554 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,482 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 554 | | Insurance broker name | INTEGRATED INSURANCE SOLUTIONS,LLC |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 206 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-06-01 | | Total amount of commissions paid to insurance broker | USD $38,197 | | Total amount of fees paid to insurance company | USD $17,795 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $38,197 | | Amount paid for insurance broker fees | 17795 | | Additional information about fees paid to insurance broker | BONUSES AND INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTERGRATED INSURA |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 126 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-06-01 | | Total amount of commissions paid to insurance broker | USD $591 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,553 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $591 | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTERGRATED INSURA |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AKZH |
| Policy instance | 1 |
| Insurance contract or identification number | G000AKZH | | Number of Individuals Covered | 102 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $5,316 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,316 | | Insurance broker organization code? | 3 | | Insurance broker name | INTEGRATED INSURANCE SOLUTIONS,LLC |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 194 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-06-01 | | Total amount of commissions paid to insurance broker | USD $38,488 | | Total amount of fees paid to insurance company | USD $13,870 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 113 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-06-01 | | Total amount of commissions paid to insurance broker | USD $311 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,225 | | 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 | 063796 |
| Policy instance | 1 |
| Insurance contract or identification number | 063796 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $5,542 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,712 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 ) |
| Policy contract number | 78622ERC |
| Policy instance | 2 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 126 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-06-01 | | Total amount of commissions paid to insurance broker | USD $321 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD &D | | Welfare Benefit Premiums Paid to Carrier | USD $6,424 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $321 | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTERGRATED INSURA |
|
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
| Policy contract number | 78622ERC |
| Policy instance | 1 |
| Insurance contract or identification number | 78622ERC | | Number of Individuals Covered | 199 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-06-01 | | Total amount of commissions paid to insurance broker | USD $36,822 | | Total amount of fees paid to insurance company | USD $14,501 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 $36,822 | | Amount paid for insurance broker fees | 14501 | | Additional information about fees paid to insurance broker | BONUSES AND INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | MELODY G. RYLAND-INTERGRATED INSURA |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 063796 |
| Policy instance | 1 |
| Insurance contract or identification number | 063796 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $5,525 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,627 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,525 | | Insurance broker name | INSURANCE UNLIMITED AGENCY INC |
|
