T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 401k Plan overview

Plan Name	T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN
Plan identification number	501

T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

T & A SUPPLY COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:	T & A SUPPLY COMPANY, INC.
Employer identification number (EIN):	910718794
NAIC Classification:	423300

Additional information about T & A SUPPLY COMPANY, INC.

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1957-12-13
Company Identification Number:	578032216
Legal Registered Office Address:	11225 SE 6TH ST STE 100 BELLEVUE United States of America (USA) 98004

More information about T & A SUPPLY COMPANY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	JOHANNA BAYLOR	2024-07-09
501	2022-01-01	JOHANNA M. BAYLOR	2023-06-28
501	2021-01-01	JOHANNA BAYLOR	2022-07-21
501	2020-01-01	RENEE LOMBARD	2021-07-14
501	2019-01-01	RENEE LOMBARD	2020-07-28
501	2018-01-01	RENEE LOMBARD	2019-08-09
501	2017-01-01
501	2016-01-01
501	2015-01-01	LAURA LANGWELL
501	2014-01-01	LYNN TAKAKI
501	2013-01-01	MARK A STRECKER
501	2012-01-01	MARK STRECKER
501	2011-01-01	MARK STRECKER
501	2009-07-01	MARK STRECKER

Plan Statistics for T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN

401k plan membership statisitcs for T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN

Measure	Date	Value
2023: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	307
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	302
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	302
Number of employers contributing to the scheme	2023-01-01	0
2022: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	312
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	307
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	307
Number of employers contributing to the scheme	2022-01-01	0
2021: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	306
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	312
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	312
Number of employers contributing to the scheme	2021-01-01	0
2020: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	309
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	304
Number of retired or separated participants receiving benefits	2020-01-01	2
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	306
Number of employers contributing to the scheme	2020-01-01	0
2019: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	281
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	305
Number of retired or separated participants receiving benefits	2019-01-01	2
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	307
Number of employers contributing to the scheme	2019-01-01	0
2018: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	262
Number of retired or separated participants receiving benefits	2018-01-01	2
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	264
Number of employers contributing to the scheme	2018-01-01	0
2017: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	231
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	231
2016: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	231
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	231
2015: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	235
Number of retired or separated participants receiving benefits	2015-01-01	2
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	237
2014: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	239
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	235
Number of retired or separated participants receiving benefits	2014-01-01	2
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	237
2013: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	237
Number of retired or separated participants receiving benefits	2013-01-01	3
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	240
2012: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	157
Number of retired or separated participants receiving benefits	2012-01-01	3
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	160
2011: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	164
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	168
2009: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	220
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	212
Number of retired or separated participants receiving benefits	2009-07-01	3
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	215

Form 5500 Responses for T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN

2023: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: T & A SUPPLY COMPANY, INC. GROUP HEALTH PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	882476
Policy instance	3
Insurance contract or identification number 882476 Number of Individuals Covered 302 Insurance policy start date 2023-01-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $37,277 Total amount of fees paid to insurance company USD $9,823 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $222,507 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	18245
Policy instance	2
Insurance contract or identification number 18245 Number of Individuals Covered 6 Insurance policy start date 2023-07-01 Insurance policy end date 2023-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $25,113 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-001
Policy instance	1
Insurance contract or identification number 15799-001 Number of Individuals Covered 5 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $71,915 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number	882479
Policy instance	4
Insurance contract or identification number 882479 Number of Individuals Covered 56 Insurance policy start date 2022-05-01 Insurance policy end date 2023-04-30 Total amount of commissions paid to insurance broker USD $579 Total amount of fees paid to insurance company USD $1,251 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided HOSPITAL,CRITICAL ILLNESS,ACCIDENT Welfare Benefit Premiums Paid to Carrier USD $32,580 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-001
Policy instance	1
Insurance contract or identification number 15799-001 Number of Individuals Covered 5 Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $80,843 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	2
Insurance contract or identification number 9405 Number of Individuals Covered 429 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $12,074 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $9,112 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	3
Insurance contract or identification number 30004047 Number of Individuals Covered 283 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $1,497 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $23,597 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,293 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	4
Insurance contract or identification number 126238 Number of Individuals Covered 96 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $5,303 Total amount of fees paid to insurance company USD $331 Life Insurance Welfare Benefit Yes Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $26,516 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,303 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	5
Insurance contract or identification number EAP Number of Individuals Covered 307 Insurance policy start date 2022-01-01 Insurance policy end date 2022-04-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $2,207 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGD607528
Policy instance	6
Insurance contract or identification number SGD607528 Number of Individuals Covered 307 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $14,058 Total amount of fees paid to insurance company USD $3,060 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $70,291 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $11,444 Amount paid for insurance broker fees 3060 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	771041
Policy instance	7
Insurance contract or identification number 771041 Number of Individuals Covered 88 Insurance policy start date 2022-01-01 Insurance policy end date 2022-04-30 Total amount of commissions paid to insurance broker USD $2,552 Total amount of fees paid to insurance company USD $1,340 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS, HOSPITAL Welfare Benefit Premiums Paid to Carrier USD $12,663 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,552 Amount paid for insurance broker fees 1340 Additional information about fees paid to insurance broker CONTINGENT COMPENSATION Insurance broker organization code? 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGM607197
Policy instance	6
Insurance contract or identification number SGM607197 Number of Individuals Covered 312 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $27,529 Total amount of fees paid to insurance company USD $2,004 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $137,646 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $27,529 Amount paid for insurance broker fees 2004 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	771041
Policy instance	7
Insurance contract or identification number 771041 Number of Individuals Covered 91 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $5,470 Total amount of fees paid to insurance company USD $1,052 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS, HOSPITAL Welfare Benefit Premiums Paid to Carrier USD $40,551 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,470 Amount paid for insurance broker fees 284 Additional information about fees paid to insurance broker CONTINGENT COMPENSATION Insurance broker organization code? 3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-001
Policy instance	1
Insurance contract or identification number 15799-001 Number of Individuals Covered 5 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $70,444 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	2
Insurance contract or identification number 9405 Number of Individuals Covered 430 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $12,800 Total amount of fees paid to insurance company USD $0 Dental 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 $12,800 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	3
Insurance contract or identification number 30004047 Number of Individuals Covered 273 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $1,191 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $22,798 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,022 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	4
Insurance contract or identification number 126238 Number of Individuals Covered 92 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $12,283 Total amount of fees paid to insurance company USD $768 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $61,416 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $12,283 Insurance broker organization code? 3 Amount paid for insurance broker fees 768 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	5
Insurance contract or identification number EAP Number of Individuals Covered 312 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 EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $6,619 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-001
Policy instance	1
Insurance contract or identification number 15799-001 Number of Individuals Covered 5 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $53,116 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	2
Insurance contract or identification number 9405 Number of Individuals Covered 429 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $10,870 Total amount of fees paid to insurance company USD $0 Dental 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 $10,870 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	3
Insurance contract or identification number 30004047 Number of Individuals Covered 276 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $1,190 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $22,662 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,190 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	4
Insurance contract or identification number 126238 Number of Individuals Covered 69 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $10,024 Total amount of fees paid to insurance company USD $627 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $50,121 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,024 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	5
Insurance contract or identification number EAP Number of Individuals Covered 305 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $6,769 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	6
Insurance contract or identification number E3856036 Number of Individuals Covered 18 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $135 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided CRITICAL ILLNESS, CANCER Welfare Benefit Premiums Paid to Carrier USD $1,005 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $92 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGM607197
Policy instance	7
Insurance contract or identification number SGM607197 Number of Individuals Covered 222 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $19,926 Total amount of fees paid to insurance company USD $1,235 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $99,789 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $19,926 Amount paid for insurance broker fees 1235 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	771041
Policy instance	8
Insurance contract or identification number 771041 Number of Individuals Covered 79 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $4,273 Total amount of fees paid to insurance company USD $569 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS, HOSPITAL Welfare Benefit Premiums Paid to Carrier USD $29,309 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,273 Amount paid for insurance broker fees 569 Additional information about fees paid to insurance broker CONTINGENT COMPENSATION Insurance broker organization code? 3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 3 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $26,295 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 357 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $64,752 Total amount of fees paid to insurance company USD $17,058 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,158,392 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $64,752 Amount paid for insurance broker fees 17058 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 419 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $11,102 Total amount of fees paid to insurance company USD $0 Dental 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 $11,102 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 272 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $799 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $21,153 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $799 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 36 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $8,038 Total amount of fees paid to insurance company USD $502 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $40,189 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,038 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	6
Insurance contract or identification number EAP Number of Individuals Covered 305 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $6,889 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	7
Insurance contract or identification number E3856036 Number of Individuals Covered 18 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $549 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided CRITICAL ILLNESS, CANCER Welfare Benefit Premiums Paid to Carrier USD $9,074 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $282 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGM607197
Policy instance	8
Insurance contract or identification number SGM607197 Number of Individuals Covered 220 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $24,160 Total amount of fees paid to insurance company USD $773 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $120,799 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $24,160 Amount paid for insurance broker fees 773 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 2 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $19,361 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 343 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $62,621 Total amount of fees paid to insurance company USD $16,309 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,087,365 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $62,621 Amount paid for insurance broker fees 16309 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 382 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $10,195 Total amount of fees paid to insurance company USD $0 Dental 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 $10,195 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 255 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,093 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $19,633 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,093 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 45 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $7,343 Total amount of fees paid to insurance company USD $459 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $36,713 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,343 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	6
Insurance contract or identification number EAP Number of Individuals Covered 279 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $5,899 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	7
Insurance contract or identification number E3856036 Number of Individuals Covered 18 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $485 Total amount of fees paid to insurance company USD $12 Other welfare benefits provided CRITICAL ILLNESS, CANCER Welfare Benefit Premiums Paid to Carrier USD $9,287 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $332 Amount paid for insurance broker fees 0 Additional information about fees paid to insurance broker FEES Insurance broker organization code? 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGM607197
Policy instance	8
Insurance contract or identification number SGM607197 Number of Individuals Covered 262 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $16,692 Total amount of fees paid to insurance company USD $1,348 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $83,459 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $16,692 Amount paid for insurance broker fees 1348 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	SGM607197
Policy instance	8
Insurance contract or identification number SGM607197 Number of Individuals Covered 231 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $18,993 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $94,961 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $18,343 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	7
Insurance contract or identification number E3856036 Number of Individuals Covered 22 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,230 Total amount of fees paid to insurance company USD $231 Other welfare benefits provided CRITICAL ILLNESS, CANCER Welfare Benefit Premiums Paid to Carrier USD $10,295 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $467 Amount paid for insurance broker fees 5 Additional information about fees paid to insurance broker FEES Insurance broker organization code? 3 Insurance broker name KENT SHERMAN AND VARIOUS AGENTS
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	EAP
Policy instance	6
Insurance contract or identification number EAP Number of Individuals Covered 263 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Welfare Benefit Premiums Paid to Carrier USD $4,319 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 52 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $8,300 Total amount of fees paid to insurance company USD $0 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $36,441 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,812 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 238 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $899 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $18,933 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $899 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	09405
Policy instance	3
Insurance contract or identification number 09405 Number of Individuals Covered 370 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $9,603 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,603 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 325 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $57,277 Total amount of fees paid to insurance company USD $14,741 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,909,240 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $57,277 Amount paid for insurance broker fees 14741 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 2 Insurance policy start date 2016-07-01 Insurance policy end date 2017-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $17,983 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	8
Insurance contract or identification number E3856036 Number of Individuals Covered 31 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $2,143 Total amount of fees paid to insurance company USD $135 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided VOLUNTARY BENEFITS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $15,437 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $836 Amount paid for insurance broker fees 11 Additional information about fees paid to insurance broker FEES Insurance broker organization code? 3 Insurance broker name LAURABETH CHRISTENSEN
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK963752
Policy instance	6
Insurance contract or identification number OK963752 Number of Individuals Covered 50 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $779 Total amount of fees paid to insurance company USD $38 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,115 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $779 Amount paid for insurance broker fees 38 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	221775
Policy instance	5
Insurance contract or identification number 221775 Number of Individuals Covered 235 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $10,186 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $80,268 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,212 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 207 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,619 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $16,188 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,619 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 345 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $7,772 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,772 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 205 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $46,741 Total amount of fees paid to insurance company USD $9,214 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,558,028 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $46,741 Amount paid for insurance broker fees 9214 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 3 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $17,014 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	00
Policy instance	9
Insurance contract or identification number 00 Number of Individuals Covered 216 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,666 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	7
Insurance contract or identification number 126238 Number of Individuals Covered 49 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $6,534 Total amount of fees paid to insurance company USD $408 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $32,669 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,534 Insurance broker organization code? 3 Amount paid for insurance broker fees 408 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 56 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $4,688 Total amount of fees paid to insurance company USD $293 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $23,438 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,688 Insurance broker organization code? 3 Amount paid for insurance broker fees 293 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK963752
Policy instance	6
Insurance contract or identification number OK963752 Number of Individuals Covered 50 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $878 Total amount of fees paid to insurance company USD $31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,511 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $878 Amount paid for insurance broker fees 31 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 203 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,729 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $17,294 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,729 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	2
Insurance contract or identification number 15799-1 Number of Individuals Covered 2 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $17,547 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	1
Insurance contract or identification number 1014490 Number of Individuals Covered 200 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $44,069 Total amount of fees paid to insurance company USD $8,523 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,470,336 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $44,069 Amount paid for insurance broker fees 8523 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	221775
Policy instance	7
Insurance contract or identification number 221775 Number of Individuals Covered 235 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $9,458 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $66,876 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,458 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 355 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $8,917 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,917 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	8
Insurance contract or identification number E3856036 Number of Individuals Covered 35 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $3,213 Total amount of fees paid to insurance company USD $526 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided VOLUNTARY BENEFITS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $22,282 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,305 Amount paid for insurance broker fees 75 Additional information about fees paid to insurance broker FEES Insurance broker organization code? 3 Insurance broker name DONALD TERRY GOTHAM
WELLSPRING FAMILY SERVICES, EAP (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number	00
Policy instance	9
Insurance contract or identification number 00 Number of Individuals Covered 216 Insurance policy start date 2014-06-15 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided EMPLOYEE ASSISTANCE PROGRAM Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,527 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 510 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $8,204 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,204 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	1
Insurance contract or identification number 1014490 Number of Individuals Covered 207 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $37,227 Total amount of fees paid to insurance company USD $7,312 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,240,885 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $37,227 Amount paid for insurance broker fees 7312 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	2
Insurance contract or identification number 15799-1 Number of Individuals Covered 4 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $15,281 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 211 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,790 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $17,905 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,790 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 54 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $6,218 Total amount of fees paid to insurance company USD $389 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $31,092 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,218 Insurance broker organization code? 3 Amount paid for insurance broker fees 389 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK963752
Policy instance	6
Insurance contract or identification number OK963752 Number of Individuals Covered 55 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,112 Total amount of fees paid to insurance company USD $30 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,260 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $1,112 Amount paid for insurance broker fees 30 Additional information about fees paid to insurance broker OVERRIDE SUPPLEMENTAL COMMISSION Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	221775
Policy instance	7
Insurance contract or identification number 221775 Number of Individuals Covered 237 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $13,317 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $66,587 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,822 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract number	E3856036
Policy instance	8
Insurance contract or identification number E3856036 Number of Individuals Covered 209 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $15,057 Total amount of fees paid to insurance company USD $729 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided VOLUNTARY BENEFITS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $79,578 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,857 Amount paid for insurance broker fees 465 Additional information about fees paid to insurance broker FEES Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	2
Insurance contract or identification number 15799-1 Number of Individuals Covered 3 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $16,702 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 479 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $8,914 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,914 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 )
Policy contract number	30004047
Policy instance	4
Insurance contract or identification number 30004047 Number of Individuals Covered 127 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,811 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $18,106 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,811 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	126238
Policy instance	5
Insurance contract or identification number 126238 Number of Individuals Covered 59 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $6,910 Total amount of fees paid to insurance company USD $432 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $34,549 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,910 Insurance broker organization code? 3 Amount paid for insurance broker fees 432 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	221775
Policy instance	7
Insurance contract or identification number 221775 Number of Individuals Covered 213 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $12,606 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $63,032 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $12,606 Insurance broker organization code? 3 Insurance broker name JAMI M. HANSEN
MHN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C5609078
Policy instance	8
Insurance contract or identification number C5609078 Number of Individuals Covered 240 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $13,055 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided VOLUNTARY BENEFITS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $59,615 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $13,055 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	1
Insurance contract or identification number 1014490 Number of Individuals Covered 203 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $34,476 Total amount of fees paid to insurance company USD $7,069 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,149,183 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $34,476 Amount paid for insurance broker fees 7069 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK963752
Policy instance	6
Insurance contract or identification number OK963752 Number of Individuals Covered 40 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,238 Total amount of fees paid to insurance company USD $24 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,683 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes Commission paid to Insurance Broker USD $1,238 Amount paid for insurance broker fees 24 Additional information about fees paid to insurance broker OVERRIDE SUPPLEMENTAL COMMISSION Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 486 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $8,290 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 166 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $37,857 Total amount of fees paid to insurance company USD $7,410 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,261,913 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 6 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $10,434 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number	1014490
Policy instance	2
Insurance contract or identification number 1014490 Number of Individuals Covered 147 Insurance policy start date 2010-07-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $17,321 Total amount of fees paid to insurance company USD $3,631 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $574,838 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $17,321 Amount paid for insurance broker fees 3631 Additional information about fees paid to insurance broker PREFERRED PRODUCER PROGRAM Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	15799-1
Policy instance	1
Insurance contract or identification number 15799-1 Number of Individuals Covered 0 Insurance policy start date 2010-07-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 )
Policy contract number	9405
Policy instance	3
Insurance contract or identification number 9405 Number of Individuals Covered 482 Insurance policy start date 2010-07-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $5,811 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,811 Insurance broker organization code? 3 Insurance broker name GALLAGHER BENEFIT SERVICES, INC.

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• T & T CONSTRUCTION, INC. 401K PROFIT SHARING PLAN [EIN = 860455394]
• T & O CONTRACTING, INC. PROFIT SHARING & 401(K) PLAN [EIN = 562366255]
• T & T CONSTRUCTION 401(K) PROFIT SHARING PLAN [EIN = 470599523]
• T & A SCREW PRODUCTS INC. 401(K) PROFIT SHARING PLAN [EIN = 061107891]
• T & B AUTO SALES, INC PROFIT SHARING PLAN [EIN = 202178500]
• T & M TRANSFER COMPANY PROFIT SHARING & 401K PLAN [EIN = 570421238]
• T & E INDUSTRIES, INC. 401(K) PLAN [EIN = 222304064]
• T & E MACHINE, INC. 401(K) PROFIT SHARING PLAN & TRUST [EIN = 550588490]
• T & T ELECTRICAL CONTRACTORS, INC. PROFIT SHARING PLAN [EIN = 042776463]
• T & C MARKETS STURGEON BAY, INC. SAVINGS & RETIREMENT PLAN [EIN = 391381573]
• T & W TOOL AND DIE, INC. 401(K) PLAN [EIN = 382473677]
• T & D SUPPLY LLC 401(K) PLAN [EIN = 753239510]
• T & S PRODUCTS 401(K) PLAN [EIN = 752297051]
• T & T GROUP, INC. 401(K) PLAN [EIN = 760310702]
• T & D FABRICATION, INC. 401K PLAN [EIN = 208846466]
• T & T CONSTRUCTION 401(K) PLAN [EIN = 593274034]
• T & S HARVESTING DEFINED BENEFIT PLAN [EIN = 651128483]
• T & S OIL COMPANY 401(K) PROFIT SHARING PLAN [EIN = 061004536]
• T & L HOSPITALITY INC. PENSION PLAN [EIN = 521865324]
• T & D GROUP HOME INC 401K PROFIT SHARING PLAN AND TRUST [EIN = 770521299]
• T & T ENG 401(K) [EIN = 760601818]
• T & W CARPET SERVICE INC 401K PLAN [EIN = 521502014]
• T & M SERVICES, INC. 401K/PROFIT SHARING PLAN [EIN = 421372127]
• T & R SERVICE COMPANY 401(K) PLAN [EIN = 460356387]
• T & M ENTERPRISES OF PA RETIREMENT PLAN [EIN = 208402109]
• T & S ELECTRIC LTD 401(K) PROFIT SHARING PLAN & TRUST [EIN = 391546597]
• T & L 401(K) PLAN [EIN = 330697967]
• T & M HAZARDOUS WASTE MANAGEMENT, LLC PROFIT SHARING PLAN [EIN = 460514850]
• T & C ROBINSON, INC. 401 (K) RETIREMENT SAVINGS PLAN [EIN = 943414640]
• T & G CLEGG FAMILY PARTNERSHIP 401(K) PROFIT SHARING PLAN [EIN = 710818220]
• T & L HOSPITALITY INC. PROFIT SHARING PLAN [EIN = 521865324]
• T & H DRYWALL PROFIT SHARING PLAN AND TRUST [EIN = 470711969]
• T & C FOR LIFE, INC. DBA MOSQUITO AUTHORITY 401(K) PLAN [EIN = 264446890]
• T & S FIRE AND SECURITY, INC. 401(K) RETIREMENT PLAN [EIN = 561095670]
• T & T JANITORIAL SERVICES 401(K) PLAN [EIN = 043003025]
• T & N FERRIS ENTERPRISES INC 401K [EIN = 542809029]
• T & N VAN SERVICE 401K PLAN [EIN = 236981955]
• T & B BOOTS, INC. 401(K) PLAN [EIN = 770164081]
• T & J MANUFACTURING PROFIT SHARING PLAN [EIN = 421225488]
• T & K MECHANICAL, INC. DEFINED BENEFIT PENSION PLAN [EIN = 954231953]
• T & S TRADING, LLC DEFINED BENEFIT PENSION PLAN [EIN = 830442896]
• T & L SPECIALTY COMPANY, INC. RETIREMENT SAVINGS PLAN [EIN = 640669352]
• T & W FINANCIAL CORPORATION PROFIT SHARING PLAN [EIN = 860517520]
• T & P, INC. 401(K) PROFIT SHARING PLAN [EIN = 470752192]
• T & L NELSON ELECTRIC, INC. 401(K) PROFIT SHARING PLAN [EIN = 421184236]
• T & W OPERATIONS INC 401(K) PLAN [EIN = 275408491]
• T & V INC. 401(K) PROFIT SHARING PLAN [EIN = 911898630]
• T & M SHAFFER ENTERPRISES, INC PROFIT SHARING [EIN = 510490858]
• T & C RETIREMENT PLAN & TRUST [EIN = 464868125]
• T & J PRINTING SUPPLY 401K PLAN [EIN = 203467677]
• T & R PHARMACEUTICAL, LLC 401(K) PLAN [EIN = 205070225]
• T & M PLASTICS CO. 401(K) PLAN [EIN = 341013692]
• T & A INDUSTRIAL, LTD. 401(K) SAVINGS PLAN [EIN = 391553370]
• T & Y MARKET 401(K) PROFIT SHARING PLAN [EIN = 264085218]
• T & R TAX SERVICE, INC. PROFIT SHARING PLAN [EIN = 850378094]
• T & P LONGVIEW FEDERAL CREDIT UNION 401(K) PLAN AND TRUST [EIN = 750835419]
• T & H/GETSCO EMPLOYEES 401(K) PLAN [EIN = 020739672]
• T & T STAFF MANAGEMENT, INC. PENSION PLAN & TRUST [EIN = 742680134]
• T & T TRANSPORTATION SERVICES, LLC 401(K) PROFIT SHARING PLAN [EIN = 030484931]
• T & S MACHINING, INC. 401(K) P/S PLAN [EIN = 582227408]
• T & B AUTO SALES, INC PENSION PLAN [EIN = 202178500]
• T & T ELECTRICAL CONTRACTORS, INC. RETIREMENT PLAN [EIN = 061408153]
• T & S SALES, INC. 401(K) PLAN [EIN = 910746513]
• T & D RESOURCES LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 272004799]
• T & G INDUSTRIES, INC. PROFIT SHARING PLAN [EIN = 112202153]
• T & G DERMATOLOGY. (APMC) PROFIT SHARING PLAN [EIN = 720791779]
• T & T DRILLING, INC. 401(K) PLAN [EIN = 952465392]
• T & L CONCRETE, LLC PROFIT SHARING PLAN [EIN = 020505199]
• T & W SALES, INC. 401(K) PLAN [EIN = 751513693]
• T & B ENGINEERING INC. 401(K) PLAN [EIN = 208983460]
• T & M CONSOLIDATED COMPANY 401K PROFIT SHARING PLAN [EIN = 812375970]
• T & M AUTO SALES, INC. 401(K) PLAN [EIN = 561932644]
• T & T TRUCKING 401(K) PROFIT SHARING PLAN [EIN = 941616637]
• T & F DRUGS, INC. PROFIT SHARING PLAN [EIN = 272095280]
• T & G CONSTRUCTORS 401(K) PLAN [EIN = 592806739]
• T & W STAMPING, INC. 401(K) PLAN [EIN = 341741463]
• T & L CONCRETE, LLC PROFIT SHARING PLAN [EIN = 020389198]
• T & P FEDERAL CREDIT UNION CAPITAL ACCUMULATION PLAN [EIN = 750823725]
• T & R ENTERPRISES OF OHIO, LLC 401(K) PLAN [EIN = 320094090]
• T & T SPORTS OF CHARLESTON INC 401K PLAN [EIN = 570634459]
• T & P MACHINE SHOP, INC. PROFIT SHARING PLAN [EIN = 942449028]
• T & G FINANCIAL SOLUTIONS, INC. 401(K) [EIN = 274292365]
• T & S 401(K) PLAN [EIN = 271433628]
• T & J HOPPER BUILDING SUPPLIES, INC. 401(K)PLAN [EIN = 251335779]
• T & W ENTERPRISES 401(K) PLAN [EIN = 331164232]
• T & H SWEEPER CO RETIREMENT PLAN [EIN = 261611458]
• T & C TOOL & SALES, INC. 401(K) P/S PLAN [EIN = 382699705]
• T & T REPRODUCTION & SUPPLIES, INC. 401(K) PLAN [EIN = 362886316]
• T & R MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 571211004]
• T & T ELECTRIC, INC. 401(K) PROFIT SHARING PLAN [EIN = 990223672]
• T & N AMERICA HERBS, INC [EIN = 912198368]
• T & D FABRICATION INC 401K PLAN [EIN = 731559573]
• T & N CHILDREN'S PUBLISHING, INC 401(K) SAVINGS PLAN [EIN = 411902517]
• T & H TRANSPORT, INC. 401(K) PLAN [EIN = 475085172]
• T & J CORE DRILLING INC NON MATCHING 401(K) PLAN [EIN = 611270401]
• T & A 401(K) PROFIT SHARING PLAN AND TRUST [EIN = 205267254]
• T & S PLUMBING, INC. RETIREMENT SAVINGS PLAN [EIN = 680484745]
• T & T MOORE ENTERPRISES CORPORATION 401(K) PROFIT SHARIN [EIN = 911448999]
• T & C FITNESS, LLC 401(K) P/S PLAN [EIN = 260291266]
• T & R RECYCLING RETIREMENT SAVINGS PLAN [EIN = 202046257]
• T & S CROP SERVICE, INC. 401(K) PLAN [EIN = 161502801]
• T & R CONTRACTING, INC. 401(K) PLAN [EIN = 460446457]
• T & T SUPPLY CO., INC. INCENTIVE SAVINGS PLAN [EIN = 371469458]
• T & K SERVICES, INC. 401(K) PLAN [EIN = 562337427]
• T & F TIRE SUPPLY CO, INC 401(K) P/S PLAN [EIN = 231763431]
• T & J SERVICES OF WEST PALM BEACH 401(K) PLAN [EIN = 710889057]
• T & T MARKETING, INC. 401(K) RATE GROUP PSP & T [EIN = 223109150]
• T & S MECHANICAL, INC. RETIREMENT PLAN [EIN = 383793801]
• T & L PAINTING, INC. DAVIS-BACON RETIREMENT PLAN [EIN = 810483307]
• T & T JEWEL HOUSE, INC. PROFIT SHARING PLAN [EIN = 990196617]
• T & T COMPLETE LANDSCAPING 401(K) PLAN [EIN = 270728461]
• T & W PARKS CONSTRUCTION, INC. DEFINED BENEFIT PENSION PLAN [EIN = 330864321]
• T & C 401(K) PLAN [EIN = 134366108]
• T & S FOR LIFE, INC. DEFINED BENEFIT PENSION PLAN [EIN = 562490881]
• T & T CONSTRUCTION MANAGEMENT GROUP, INC. 401(K) SAVINGS PLAN [EIN = 471928025]
• T & T AUDIO VISUAL, INC. CASH BALANCE PLAN [EIN = 262467847]
• T & T AUDIO VISUAL, INC. 401(K) PLAN [EIN = 262467847]
• T & A PRECISION MACHINE, INC. 401(K) PLAN [EIN = 262473679]
• T & D PRODUCTS, INC. PROFIT SHARING PLAN AND TRUST [EIN = 363932415]
• T & J CONCRETE & MASONRY 401K PLAN [EIN = 411804422]
• T & H MANAGEMENT, INC 401(K) PLAN [EIN = 352162613]
• T & S FAMILY PETS, INC. 401K PLAN [EIN = 271011975]
• T & K LUMBER COMPANY, INC. 401(K) RETIREMENT PLAN [EIN = 161346878]
• T & S INTERMODAL MAINTENANCE, INC. 401(K) PROFIT SHARING PLAN AND TRUST [EIN = 680479675]
• T & C PLUMBING, LLC 401(K) PROFIT SHARING PLAN [EIN = 990351614]
• T & D METAL PRODUCTS COMPANY EMPLOYEES' SAVINGS & PROFIT SHARING PLAN [EIN = 371356982]
• T & M REALTY 401(K) PLAN [EIN = 043157685]
• T & W TRUCKING COMPANY EMPLOYEES PROFIT SHARING PLAN [EIN = 363520084]
• T & H ELECTRIC INC. PROFIT SHARING PLAN [EIN = 521297888]
• T & E CATTLE COMPANY 401(K) PROFIT SHARING PLAN [EIN = 470535162]
• T & O REFRIGERATION, INC. 401K [EIN = 581773870]
• T & S HOLDINGS, INC. 401(K) PLAN [EIN = 260308902]
• T & T ENGINEERING LLC [EIN = 860805493]
• T & S SAWMILL, INC. 401(K) PLAN [EIN = 710504425]
• T & S MACHINING, INC. RETIREMENT PLAN [EIN = 431727570]
• T & C FOODS, INC. SAVINGS AND RETIREMENT PLAN [EIN = 391865693]
• T & M ASSOCIATES EMPLOYEE WELFARE PLAN [EIN = 221806708]
• T & S CONSTRUCTION COMPANY, INC. PROFIT SHARING PL [EIN = 880118410]
• T & M TECHNOLOGY RETIREMENT PLAN [EIN = 660598334]
• T & D MANAGEMENT ENT. INC SEPARATE TRUST [EIN = 860838412]
• T & W CORPORATION 401K PROFIT SHARING PLAN [EIN = 351089282]
• T & L STONE LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 383910931]
• T & T ENTERPRISES OF OHIO, INC. EMPLOYEE BENEFIT PLAN [EIN = 203036050]
• T & G INDUSTRIES, INC. HEALTH PLAN [EIN = 112202153]
• T & R MARKET, INC. PROFIT SHARING PLAN AND TRUST [EIN = 850225623]
• T & K FARMS, INC. 401K PROFIT SHARING PLAN [EIN = 820245638]
• T & B EQUIPMENT COMPANY BENEFITS PLAN [EIN = 561177868]
• T & D RESTAURANT GROUP RETIREMENT PLAN [EIN = 810890759]
• T & K AUTO RETIREMENT PLAN [EIN = 822936781]
• T & T CONSTRUCTION 401(K) PROFIT SHARING PLAN [EIN = 470796800]
• T & T CONSTRUCTION CO INC. [EIN = 363063054]
• T & G SPECIALTIES LLC 401(K) P/S PLAN [EIN = 431933349]
• T & O TOOL & DIE, INC. 401(K) PLAN [EIN = 815227782]
• T & C ENTERPRISES, INC. 401(K) PROFIT SHARING PLAN [EIN = 820811977]
• T & D SYSTEMS EMPLOYEE HEALTH BENEFIT PLAN [EIN = 751992982]
• T & J AGNES THEATRES, INC. 401K PLAN [EIN = 450432008]
• T & S HOIST & RIGGING 401(K) PLAN [EIN = 330714939]
• T & M MECHANICAL SALES CO., INC. EMPLOYEES DEFERRED COMP [EIN = 953371213]
• T & E TOOLBOX SALES RETIREMENT PLAN [EIN = 273972310]
• T & G INDUSTRIES, INC. HEALTH PLAN [EIN = 112202153]
• T & L ENTERPRISES, INCORPORATED 401(K) PLAN [EIN = 452022449]
• T & W VENTURES, INC. 401K PLAN [EIN = 900391009]
• T & M MECHANICAL SALES CO., INC. PROFIT SHARING RETIREMENT PLAN [EIN = 953371213]
• T & R BANGI AG SERVICES [EIN = 770405066]
• T & T RETIREMENT PLAN [EIN = 221913613]
• T & M TILT-UP, INC. PROFIT SHARING PLAN [EIN = 581638273]
• T & H GROUP SAVINGS PLAN [EIN = 203860457]
• T & H ELECTRICAL CORPORATION CIGNA HEALTH AND LIFE INSURANCE COMPANY [EIN = 020739672]
• T & T DRYWALL 401(K) PLAN [EIN = 204963335]
• T & D INTERIORS, INC. SOCA BENEFIT PLAN [EIN = 341436173]
• T & T LEASING 401(K) PLAN [EIN = 141829067]
• T & R PAINTING & DRYWALL, INC. 401(K) PROFIT SHARING PLAN [EIN = 954769333]
• T & H CUSTOM VENEERS INC 401K PLAN [EIN = 050545261]
• T & M AUTO SPECIALISTS, INC. 401 K PROFIT SHARING PLAN AND TRUST [EIN = 621429007]
• T & J ELECTRICAL CORPORATION PROFIT SHARING PLAN [EIN = 141627408]
• T & L TRANSPORT, INC. 401(K) P/S PLAN [EIN = 341664651]
• T & T MONAHAN REALTY, INC. [EIN = 200703726]
• T & M CONCEPTS, INC MONEY PURCHASE PENSION [EIN = 341725373]
• T & M CONSTRUCTION, INC. PROFIT SHARING PLAN [EIN = 953489055]
• T & R WYSE, INC. DEFINED BENEFIT PENSION PLAN [EIN = 860479530]
• T & T CONSULTING, INC. 401(K) PROFIT SHARING PLAN [EIN = 710932759]
• T & W IMPORTS, INC., 401(K) PROFIT SHARING PLAN [EIN = 954520093]
• T & K RESTAURANT FRANCHISE GROUP INC SAVINGS PLAN [EIN = 411724083]
• T & T TRUCKING WELFARE BENEFITS PLAN [EIN = 941616637]
• T & T BUSINESS CORP. PROFIT SHARING PLAN [EIN = 262671814]
• T & T DIVERSIFIED, INC. 401K RETIREMENT SAVINGS PLAN [EIN = 990335210]
• T & T INDUSTRIES, INC. - 125 CAFETERIA PLAN [EIN = 941712252]
• T & C FEDERAL CREDIT UNION 401K PLAN [EIN = 381358846]
• T & D TRUCKING, INC. 401(K) PLAN [EIN = 411373847]
• T & T MECHANICAL, LLC 401(K) PLAN [EIN = 464420390]
• T & T CARE INC. 401(K) PROFIT SHARING PLAN [EIN = 473749950]
• T & D MORAVITS AND COMPANY 401(K) PLAN [EIN = 742916787]
• T & D SERVICES, INC. 401(K) PLAN [EIN = 010626948]
• T & J ENTERPRISES 401K PLAN [EIN = 474533477]
• T & D INTERIORS 401(K) PROFIT SHARING PLAN [EIN = 341436173]
• T & S BUSS INC. 401(K) PLAN [EIN = 824911817]
• T & B ELECTRIC LLC 401(K) PROFIT SHARING PLAN [EIN = 541713993]
• T & C SEAL COATING, INC. P/S PLAN [EIN = 860688569]
• T & L CONSTRUCTION CO. 401(K) PLAN [EIN = 820710099]
• T & M MANAGEMENT INC 401K PROFIT SHARING PLAN [EIN = 823428655]
• T & M MECHANICAL - 401(K) [EIN = 331224412]
• T & M ENTERPRISE, INC. 401(K) PLAN [EIN = 431948765]
• T & J MATERIALS LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 824149104]
• T & R TRANSPORT 401(K) PLAN [EIN = 450438541]
• T & B WATER TRUCKS 401(K) PROFIT SHARING PLAN & TRUST [EIN = 810700983]
• T & T OILFIELD SERVICE INC. 401K PLAN [EIN = 471268566]
• T & T MANUFACTURING LLC 401(K) PLAN [EIN = 844404336]
• T & H HOMEBUILDERS, INC. 401(K) PLAN [EIN = 472483097]
• T & T ENTERPRISES LLC 401K PLAN [EIN = 830405298]
• T & S CLOTHING, LLC 401(K) PROFIT SHARING PLAN [EIN = 811697875]
• T & K CLEANING SERVICES 401(K) PROFIT SHARING PLAN & TRUST [EIN = 825154271]
• T & H MACHINE, INC. 401(K) P/S PLAN [EIN = 911782665]
• T & T PUMP CO CBWV BENEFIT PLAN [EIN = 550484869]
• T & T CARE INC. CASH BALANCE PENSION PLAN [EIN = 473749950]
• T & H FEED SERVICE, INC. CBS BENEFIT PLAN [EIN = 610705949]
• T & W SERVICES, INC. GCF BENEFIT PLAN [EIN = 200058858]
• T & D MECHANICAL, INC GCF BENEFIT PLAN [EIN = 581541476]
• T & S PLUMBING SERVICES, INC GCF BENEFIT PLAN [EIN = 582572664]
• T & B TUBE COMPANY, INC. GROUP LIFE AND DISABILITY INSURANCE PLAN [EIN = 363183974]
• T & G ASSET HOLDINGS INC 401(K) PLAN [EIN = 841896845]
• T & T MANUFACTURING CO DBA L & M MANUFACTURING SELF FUNDED MEDICAL REIMBURSEMENT PLAN [EIN = 830339880]
• T & C FOODS INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 311443608]
• T & C WAKE GREENVILLE, INC. RETIREMENT PLAN [EIN = 823670356]
• T & R OF VALPARAISO, INC. [EIN = 275229232]
• T & B WELDING AND TRAILERS MCF BENEFIT PLAN [EIN = 202376542]
• T & T ABSTRACTS OF NJ INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 461221900]
• T & T ENTERPRISES 401(K) RETIREMENT PLAN [EIN = 820447182]
• T & T REALTY MANAGEMENT 401(K) PLAN [EIN = 261746686]
• T & R TRANSPORTATION INC CHAMBER BENEFIT ARRANGEMENT PLAN [EIN = 341879725]
• T & P SERVICES LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 200592725]
• T & T DELIVERY SERVICE LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 813734985]
• T & D BAR AND GRILL, INC. 401(K) PLAN [EIN = 851377715]
• T & R PROPERTIES, INC. EMPLOYEE BENEFITS PLAN [EIN = 382484843]
• T & M SURVEYING, INC. 401(K) PROFIT SHARING PLAN [EIN = 822465153]
• T & T CONSTRUCTION MANAGEMENT GROUP, INC. EMPLOYEE BENEFITS PLAN [EIN = 471928025]
• T & L HAWAIIAN WEAR, INC. 401(K) PLAN [EIN = 990253095]
• T & T MART ENTERPRISE, LLC 401(K) PLAN [EIN = 843981788]
• T & S INVESTMENTS 401(K) PLAN [EIN = 824609969]
• T & M SURVEYING, INC. DEFINED BENEFIT PENSION PLAN [EIN = 822465153]
• T & T DRUGS INC CBS BENEFIT PLAN [EIN = 610663306]
• T & H CUSTOM AG LLC [EIN = 824669307]
• T & D MASON FARMS, LLC GFB BENEFIT PLAN [EIN = 421568454]
• T & STRAND HOLDINGS LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 853372571]
• T & L FOOD INC 001401(K) PROFIT SHARING PLAN & TRUST [EIN = 330620631]
• T & H TRANSPORT MEDOVA LIFESTYLE HEALTH PLAN [EIN = 371620342]
• T & H ACCOUNTING SERVICES INC. 401-K PLAN [EIN = 384124573]
• T & R TRIMS LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 850984114]
• T & L FOOD INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 330621631]
• T & T TIRE POINT S AUTO SERVICE 401(K) PLAN [EIN = 910950996]
• T &C UNDERGROUND INC 401K PLAN [EIN = 262890138]
• T & T ACCOUNTING & TAX SERVICES 401(K) PROFIT SHARING PLAN [EIN = 202187250]
• T & B UNDERCAR REPAIR INC [EIN = 232799501]
• T & K GROOMING LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 475273129]
• T & BEER INC [EIN = 133736341]
• T & R CONTRACTING SERVICES LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 824678160]
• T & D POOL CONSTRUCTION, INC. 401(K) PLAN [EIN = 833163966]
• T & W MEAT CO., LLC 401(K) PLAN [EIN = 844155929]
• T & L AUTO CARE, INC. 401(K) RETIREMENT PLAN [EIN = 204997845]
• T & D'S DC, LLC 401(K) PLAN [EIN = 861289722]
• T & Z CONCRETE & CONSTRUCTION LLC SOCA BENEFIT PLAN [EIN = 863890683]
• T & L NARROW INC. RETIREMENT PLAN [EIN = 872979962]
• T & T LIBERTY SAFES, INC. 401(K) PLAN [EIN = 320255663]
• T & C SCHLENNER, LLC 401-K [EIN = 814752142]
• T & J WOODWORKS, INC. 401(K) PLAN [EIN = 205233990]
• T & T CREATIVE MEDIA LLC 401(K) PLAN [EIN = 824381550]
• T & J SERVICES LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 465033009]
• T & D SHEET METAL LLC [EIN = 205990667]
• T & C TAX SERVICES - 401(K) [EIN = 270792658]
• T & J DISTRIBUTING 401(K) PLAN [EIN = 300563402]
• T & R RECOVERY 401(K) PLAN [EIN = 863578754]
• T & T LAWNS PLUS 401K PLAN [EIN = 901134119]
• T & H TRANSPORT, INC. 401(K) PLAN [EIN = 201088656]
• T & R FARMS, INC. 401(K) PROFIT SHARING PLAN AND TRUST [EIN = 830580300]
• T & E LOGISTICS LLC 401(K) PLAN [EIN = 844630114]
• T & G ATTORNEYS 401(K) PLAN [EIN = 871481205]
• T & K CONTRACTORS INC - 401(K) [EIN = 222542612]
• T & S TOOL SUPPLY WELFARE PLAN [EIN = 341407162]
• T & R TOTAL LAWN CARE 401 (K) PLAN [EIN = 205037660]
• T & S PROFESSIONAL RENTALS EMPLOYEES 401(K) RETIREMENT SAVINGS PLAN [EIN = 202340932]
• T & J EXCAVATING WELFARE PLAN [EIN = 474283475]
• T & J ROOTER, INC WELFARE PLAN B [EIN = 462071388]
• T & J ROOTER, INC WELFARE PLAN A [EIN = 462071388]
• T & J ROOTER INC WELFARE PLAN C [EIN = 462071388]
• T & S CUSTOM HOMES 401(K) PLAN [EIN = 204090447]
• T & H BAKERY 401(K) PLAN [EIN = 920837227]
• T & T CONSTRUCTION 401(K) PLAN [EIN = 873447151]
• T & W HOLDINGS AKRON 401(K) PLAN [EIN = 883088319]
• T & S CLEANUP & REPAIRS LLC 401(K) PLAN [EIN = 262448008]
• T & J GRAVEL PRODUCTS 401(K) PLAN [EIN = 920163256]
• T & T ENTERPRISES OF NEW HAMPSHIRE, INC. PROFIT SHARING PLAN [EIN = 933275020]
• T & C RAMPS & DECKS PLUS LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 454246236]
• T & J TAX LLC 401(K) PLAN [EIN = 273504928]
• T & H AUTO SERVICE 401(K) PLAN [EIN = 833556463]
• T & S 401(K) PLAN [EIN = 262990470]
• T & J ZAFIRIS, LLC 401(K) PLAN [EIN = 830857308]
• T & M TRUCKING, INC. 401(K) PLAN [EIN = 371412465]
• T & L TRANSPORTATION 401(K) PLAN [EIN = 223085376]
• T & JJS SUPREME STEAK AND CATERING INC [EIN = 364502362]
• T & N STEEL INC 401(K) [EIN = 473193079]
• T & J LIMITED CO [EIN = 883557651]
• T & D AC, INC. 401(K) PROFIT SHARING PLAN [EIN = 921345078]
• T & M MANUFACTURING EMPLOYEE STOCK OWNERSHIP PLAN [EIN = 870578345]
• T & K CONSTRUCTION AND REMODELING [EIN = 832192030]
• T & S HOME CARE AGENCY LLC 401(K) PLAN [EIN = 813971778]
• T & T ENTERPRISES MCF BENEFIT PLAN [EIN = 431473870]
• T & M FARMS 401(K) PROFIT SHARING PLAN AND TRUST [EIN = 770298885]
• T & P AGRICULTURE, LLC PROFIT SHARING 401(K) PLAN [EIN = 931524032]