BEHAVIORAL HEALTH NETWORK, INC. has sponsored the creation of one or more 401k plans.
Additional information about BEHAVIORAL HEALTH NETWORK, INC.
Submission information for form 5500 for 401k plan PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK
401k plan membership statisitcs for PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK
| Measure | Date | Value |
|---|
| 2022: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 1,574 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 1,657 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 8 |
| Total of all active and inactive participants | 2022-07-01 | 1,665 |
| 2021: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 1,424 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 1,573 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 1 |
| Total of all active and inactive participants | 2021-07-01 | 1,574 |
| 2020: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 1,365 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 1,416 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 8 |
| Total of all active and inactive participants | 2020-07-01 | 1,424 |
| 2019: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 1,390 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 1,352 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 13 |
| Total of all active and inactive participants | 2019-07-01 | 1,365 |
| 2018: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 1,091 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 1,378 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 12 |
| Total of all active and inactive participants | 2018-07-01 | 1,390 |
| 2017: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 1,215 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 1,086 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 5 |
| Total of all active and inactive participants | 2017-07-01 | 1,091 |
| 2016: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 1,132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 1,205 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 10 |
| Total of all active and inactive participants | 2016-07-01 | 1,215 |
| 2015: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 841 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 1,132 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 6 |
| Total of all active and inactive participants | 2015-07-01 | 1,138 |
| 2014: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 1,140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 836 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 5 |
| Total of all active and inactive participants | 2014-07-01 | 841 |
| 2013: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 1,300 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 2,559 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 6 |
| Total of all active and inactive participants | 2013-07-01 | 2,565 |
| Total participants | 2013-07-01 | 2,565 |
| 2012: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 1,105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 1,293 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 7 |
| Total of all active and inactive participants | 2012-07-01 | 1,300 |
| 2011: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 841 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 1,105 |
| Total of all active and inactive participants | 2011-07-01 | 1,105 |
| Total participants | 2011-07-01 | 1,105 |
| 2010: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-07-01 | 775 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 841 |
| Total of all active and inactive participants | 2010-07-01 | 841 |
| Total participants | 2010-07-01 | 841 |
| 2009: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 690 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 775 |
| Total of all active and inactive participants | 2009-07-01 | 775 |
| Total participants | 2009-07-01 | 775 |
| 2007: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-07-01 | 759 |
| Total of all active and inactive participants | 2007-07-01 | 759 |
| 2022: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2010 form 5500 responses |
|---|
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2008 form 5500 responses |
|---|
| 2008-07-01 | Type of plan entity | Single employer plan |
| 2008-07-01 | Submission has been amended | No |
| 2008-07-01 | This submission is the final filing | No |
| 2008-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-07-01 | Plan is a collectively bargained plan | No |
| 2007: PRE-TAX BENEFIT PLAN FOR EMPLOYEES OF THE BEHAVIORAL HEALTH NETWORK 2007 form 5500 responses |
|---|
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | First time form 5500 has been submitted | Yes |
| 2007-07-01 | This submission is the final filing | No |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550037 |
| Policy instance | 2 |
| Insurance contract or identification number | 00550037 | | Number of Individuals Covered | 1005 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $19,933 | | Total amount of fees paid to insurance company | USD $23,813 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,933 | | Amount paid for insurance broker fees | 23813 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 843 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $135,908 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $135,908 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550036 |
| Policy instance | 3 |
| Insurance contract or identification number | 00550036 | | Number of Individuals Covered | 1657 | | 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 $7,231 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 7231 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550036 |
| Policy instance | 3 |
| Insurance contract or identification number | 00550036 | | Number of Individuals Covered | 1573 | | 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 $5,900 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $197,741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 5900 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550037 |
| Policy instance | 2 |
| Insurance contract or identification number | 00550037 | | Number of Individuals Covered | 1005 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $16,371 | | Total amount of fees paid to insurance company | USD $19,532 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $722,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,371 | | Amount paid for insurance broker fees | 19532 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 870 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $192,089 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $192,089 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550037 |
| Policy instance | 2 |
| Insurance contract or identification number | 00550037 | | Number of Individuals Covered | 873 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $11,336 | | Total amount of fees paid to insurance company | USD $17,614 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $702,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,336 | | Amount paid for insurance broker fees | 17614 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 761 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $152,658 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $152,658 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550036 |
| Policy instance | 3 |
| Insurance contract or identification number | 00550036 | | Number of Individuals Covered | 1416 | | 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 $5,691 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $210,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 5691 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550037 |
| Policy instance | 2 |
| Insurance contract or identification number | 00550037 | | Number of Individuals Covered | 886 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $9,886 | | Total amount of fees paid to insurance company | USD $15,540 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $735,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,886 | | Amount paid for insurance broker fees | 15540 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 740 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $174,167 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $174,167 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550036 |
| Policy instance | 3 |
| Insurance contract or identification number | 00550036 | | Number of Individuals Covered | 1352 | | 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 $10,396 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $232,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 10396 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 724 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550037 |
| Policy instance | 2 |
| Insurance contract or identification number | 00550037 | | Number of Individuals Covered | 891 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $6,826 | | Total amount of fees paid to insurance company | USD $11,151 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $613,814 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,826 | | Amount paid for insurance broker fees | 11151 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00550036 |
| Policy instance | 3 |
| Insurance contract or identification number | 00550036 | | Number of Individuals Covered | 1378 | | 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 $6,103 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $172,842 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 6103 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 679 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0200173 |
| Policy instance | 4 |
| Insurance contract or identification number | 0200173 | | Number of Individuals Covered | 1812 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $9,083 | | Total amount of fees paid to insurance company | USD $48 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0200168 |
| Policy instance | 3 |
| Insurance contract or identification number | 0200168 | | Number of Individuals Covered | 1812 | | 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 $2,375 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $635,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0161003 |
| Policy instance | 2 |
| Insurance contract or identification number | 0161003 | | Number of Individuals Covered | 209 | | 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 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,937 | | 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 | LK964603 |
| Policy instance | 8 |
| Insurance contract or identification number | LK964603 | | Number of Individuals Covered | 988 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $4,542 | | Total amount of fees paid to insurance company | USD $1,841 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,542 | | Amount paid for insurance broker fees | 1841 | | Additional information about fees paid to insurance broker | INCENTIVE BONUS PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966698 |
| Policy instance | 7 |
| Insurance contract or identification number | FLX966698 | | Number of Individuals Covered | 1138 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $2,665 | | Total amount of fees paid to insurance company | USD $1,012 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,939 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,665 | | Amount paid for insurance broker fees | 1012 | | Additional information about fees paid to insurance broker | INCENTIVE BONUS PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0161003 |
| Policy instance | 6 |
| Insurance contract or identification number | 0161003 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $776 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $776 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK-968220 |
| Policy instance | 5 |
| Insurance contract or identification number | OK-968220 | | Number of Individuals Covered | 1138 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-07-01 | | Total amount of commissions paid to insurance broker | USD $663 | | Total amount of fees paid to insurance company | USD $134 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $6,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $663 | | Amount paid for insurance broker fees | 134 | | Additional information about fees paid to insurance broker | INCENTIVE BONUS PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 4 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $1,412 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $911 | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL NEW ENGLAND LLC |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3229192 |
| Policy instance | 3 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $15,444 | | Total amount of fees paid to insurance company | USD $1,413 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $101,539 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,224 | | Amount paid for insurance broker fees | 147 | | Additional information about fees paid to insurance broker | SERVICE/ GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | HABERMAN INSURANCE GROUP INC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337871 |
| Policy instance | 2 |
| Insurance contract or identification number | 3337871 | | Number of Individuals Covered | 711 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $13,582 | | Total amount of fees paid to insurance company | USD $1,000 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $346,266 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,582 | | Amount paid for insurance broker fees | 1000 | | Additional information about fees paid to insurance broker | SERVICE/ GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 650 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $75,519 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,347,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,519 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 489 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $140,734 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $140,734 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3337871 |
| Policy instance | 2 |
| Insurance contract or identification number | 3337871 | | Number of Individuals Covered | 532 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $10,704 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $272,639 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,704 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 124111 |
| Policy instance | 4 |
| Insurance contract or identification number | LTD 124111 | | Number of Individuals Covered | 743 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $4,667 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,732 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,667 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3229192 |
| Policy instance | 5 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $15,646 | | Total amount of fees paid to insurance company | USD $1,710 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $99,421 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,641 | | Amount paid for insurance broker fees | 166 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT D. STEBBINS |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 6 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 241 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,132 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,890 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,132 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151290 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 151290 | | Number of Individuals Covered | 841 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $2,810 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $44,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,810 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05983549 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05983549 | | Number of Individuals Covered | 1140 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $6,922 | | Total amount of fees paid to insurance company | USD $3,220 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $289,216 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,922 | | Amount paid for insurance broker fees | 3220 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 124111 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 124111 | | Number of Individuals Covered | 2565 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $3,693 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,693 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3229192 |
| Policy instance | 6 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $13,115 | | Total amount of fees paid to insurance company | USD $1,839 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $91,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,792 | | Amount paid for insurance broker fees | 138 | | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | | Insurance broker organization code? | 3 | | Insurance broker name | FIELD EDDY & BULKLEY INC. |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL 151290 |
| Policy instance | 4 |
| Insurance contract or identification number | GL 151290 | | Number of Individuals Covered | 1435 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,112 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $32,274 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,112 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 2 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,019 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,019 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 486 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $99,606 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $99,606 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 466 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $117,869 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,521,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $117,869 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3229192 |
| Policy instance | 2 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $16,282 | | Total amount of fees paid to insurance company | USD $1,977 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,703 | | Amount paid for insurance broker fees | 400 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | TD INSURANCE INC. |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05983549 |
| Policy instance | 4 |
| Insurance contract or identification number | TM05983549 | | Number of Individuals Covered | 1293 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $13,716 | | Total amount of fees paid to insurance company | USD $3,477 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $402,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,716 | | Amount paid for insurance broker fees | 3477 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 3 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,130 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,845 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,130 | | Insurance broker organization code? | 3 | | Insurance broker name | DUKE INSURANCE BROKERAGE INC. |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $105,385 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,209,315 | | 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 | E3229192 |
| Policy instance | 2 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $16,920 | | Total amount of fees paid to insurance company | USD $2,198 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 3 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $975 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | 148640 & 122168 |
| Policy instance | 5 |
| Insurance contract or identification number | 148640 & 122168 | | Number of Individuals Covered | 696 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $7,961 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $90,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05983549 |
| Policy instance | 4 |
| Insurance contract or identification number | TM05983549 | | Number of Individuals Covered | 1105 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $6,581 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $330,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115744 |
| Policy instance | 1 |
| Insurance contract or identification number | 115744 | | Number of Individuals Covered | 455 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $111,216 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,426,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | MLN00705 |
| Policy instance | 2 |
| Insurance contract or identification number | MLN00705 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $2,792 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $27,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
| Policy contract number | 000501 |
| Policy instance | 3 |
| Insurance contract or identification number | 000501 | | Number of Individuals Covered | 841 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $7,361 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $318,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3229192 |
| Policy instance | 5 |
| Insurance contract or identification number | E3229192 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $20,290 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 ) |
| Policy contract number | 30019719 |
| Policy instance | 6 |
| Insurance contract or identification number | 30019719 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $756 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,175 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK961714 |
| Policy instance | 4 |
| Insurance contract or identification number | LK961714 | | Number of Individuals Covered | 582 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $2,795 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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