Insurance contract or identification number | 50019448 |
Number of Individuals Covered | 122 |
Insurance policy start date | 2017-10-01 |
Insurance policy end date | 2018-09-30 |
Total amount of commissions paid to insurance broker | USD $3,895 |
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 | 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 $17,787 |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
Commission paid to Insurance Broker | USD $2,392 |
Amount paid for insurance broker fees | 0 |
Additional information about fees paid to insurance broker | BROKER COMMISSIONS |
Insurance broker organization code? | 3 |