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AFSCME MAINE MEMBERSHIP BENEFIT FUND 401k Plan overview

Plan NameAFSCME MAINE MEMBERSHIP BENEFIT FUND
Plan identification number 501

AFSCME MAINE MEMBERSHIP BENEFIT FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Other welfare benefit cover
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

AFSCME COUNCIL 93 has sponsored the creation of one or more 401k plans.

Company Name:AFSCME COUNCIL 93
Employer identification number (EIN):042607134
NAIC Classification:813930
NAIC Description:Labor Unions and Similar Labor Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFSCME MAINE MEMBERSHIP BENEFIT FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01DOUGLAS SNOWMAN2023-01-05
5012020-01-01DOUG SNOWMAN2021-10-14
5012020-01-01DOUG SNOWMAN2022-06-27
5012019-01-01DOUG SNOWMAN2020-10-15
5012019-01-01DOUG SNOWMAN2021-01-28
5012018-01-01DOUG SNOWMAN2019-10-15
5012018-01-01DOUG SNOWMAN2020-01-10
5012017-01-01
5012017-01-01
5012016-01-01DOUG SNOWMAN
5012015-01-01BRIAN LIBBY
5012014-01-01BRIAN LIBBY
5012013-01-01
5012012-01-01BRIAN LIBBY
5012009-01-01BRIAN LIBBY, LIBBY ASSOCIATES LLC

Plan Statistics for AFSCME MAINE MEMBERSHIP BENEFIT FUND

401k plan membership statisitcs for AFSCME MAINE MEMBERSHIP BENEFIT FUND

Measure Date Value
2021: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2021 401k membership
Total participants, beginning-of-year2021-01-01685
Total number of active participants reported on line 7a of the Form 55002021-01-01609
Total of all active and inactive participants2021-01-01609
2020: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2020 401k membership
Total participants, beginning-of-year2020-01-01716
Total number of active participants reported on line 7a of the Form 55002020-01-01685
Total of all active and inactive participants2020-01-01685
2019: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2019 401k membership
Total participants, beginning-of-year2019-01-01760
Total number of active participants reported on line 7a of the Form 55002019-01-01716
Total of all active and inactive participants2019-01-01716
2018: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2018 401k membership
Total participants, beginning-of-year2018-01-01830
Total number of active participants reported on line 7a of the Form 55002018-01-01760
Total of all active and inactive participants2018-01-01760
Number of employers contributing to the scheme2018-01-010
2017: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2017 401k membership
Total participants, beginning-of-year2017-01-01649
Total number of active participants reported on line 7a of the Form 55002017-01-01663
Total of all active and inactive participants2017-01-01663
Number of employers contributing to the scheme2017-01-0139
2016: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2016 401k membership
Total participants, beginning-of-year2016-01-01599
Total number of active participants reported on line 7a of the Form 55002016-01-01600
Total of all active and inactive participants2016-01-01600
Total participants2016-01-01600
Number of employers contributing to the scheme2016-01-0139
2015: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2015 401k membership
Total participants, beginning-of-year2015-01-01636
Total number of active participants reported on line 7a of the Form 55002015-01-01599
Total of all active and inactive participants2015-01-01599
Total participants2015-01-010
Number of employers contributing to the scheme2015-01-0146
2014: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2014 401k membership
Total participants, beginning-of-year2014-01-01649
Total number of active participants reported on line 7a of the Form 55002014-01-01636
Total of all active and inactive participants2014-01-01636
Total participants2014-01-010
Number of employers contributing to the scheme2014-01-0147
2013: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2013 401k membership
Total participants, beginning-of-year2013-01-01655
Total number of active participants reported on line 7a of the Form 55002013-01-01649
Total of all active and inactive participants2013-01-01649
Total participants2013-01-01649
Number of employers contributing to the scheme2013-01-0148
2012: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2012 401k membership
Total participants, beginning-of-year2012-01-01655
Total number of active participants reported on line 7a of the Form 55002012-01-01655
Total of all active and inactive participants2012-01-01655
Total participants2012-01-01655
Number of employers contributing to the scheme2012-01-01655
2009: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2009 401k membership
Total participants, beginning-of-year2009-01-01686
Total number of active participants reported on line 7a of the Form 55002009-01-01655
Total of all active and inactive participants2009-01-01655
Total participants2009-01-01655
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
Number of employers contributing to the scheme2009-01-0114

Financial Data on AFSCME MAINE MEMBERSHIP BENEFIT FUND

Measure Date Value
2021 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$25
Total income from all sources (including contributions)2021-12-31$767,932
Total of all expenses incurred2021-12-31$949,540
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$824,050
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$682,214
Value of total assets at end of year2021-12-31$25
Value of total assets at beginning of year2021-12-31$181,633
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$125,490
Total interest from all sources2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$23,200
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$300,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$682,214
Other income not declared elsewhere2021-12-31$85,718
Administrative expenses (other) incurred2021-12-31$10,040
Liabilities. Value of operating payables at end of year2021-12-31$25
Total non interest bearing cash at end of year2021-12-31$25
Total non interest bearing cash at beginning of year2021-12-31$181,633
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-181,608
Value of net assets at end of year (total assets less liabilities)2021-12-31$25
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$181,633
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$824,050
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contract administrator fees2021-12-31$92,250
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2021-12-31010523282
2020 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$1,031,367
Total of all expenses incurred2020-12-31$1,018,729
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$898,726
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$941,874
Value of total assets at end of year2020-12-31$181,633
Value of total assets at beginning of year2020-12-31$168,995
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$120,003
Total interest from all sources2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$16,148
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$300,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$941,874
Other income not declared elsewhere2020-12-31$89,493
Administrative expenses (other) incurred2020-12-31$9,028
Total non interest bearing cash at end of year2020-12-31$181,633
Total non interest bearing cash at beginning of year2020-12-31$168,995
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$12,638
Value of net assets at end of year (total assets less liabilities)2020-12-31$181,633
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$168,995
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$898,726
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contract administrator fees2020-12-31$94,827
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2020-12-31010523282
2019 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$1,041,874
Total income from all sources (including contributions)2019-12-31$1,041,874
Total of all expenses incurred2019-12-31$983,716
Total of all expenses incurred2019-12-31$983,716
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$857,512
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$857,512
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$980,649
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$980,649
Value of total assets at end of year2019-12-31$168,995
Value of total assets at end of year2019-12-31$168,995
Value of total assets at beginning of year2019-12-31$110,837
Value of total assets at beginning of year2019-12-31$110,837
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$126,204
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$126,204
Total interest from all sources2019-12-31$12
Total interest from all sources2019-12-31$12
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$10,421
Administrative expenses professional fees incurred2019-12-31$10,421
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$300,000
Value of fidelity bond cover2019-12-31$300,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$980,649
Contributions received from participants2019-12-31$980,649
Other income not declared elsewhere2019-12-31$61,213
Other income not declared elsewhere2019-12-31$61,213
Administrative expenses (other) incurred2019-12-31$17,337
Administrative expenses (other) incurred2019-12-31$17,337
Total non interest bearing cash at end of year2019-12-31$168,995
Total non interest bearing cash at end of year2019-12-31$168,995
Total non interest bearing cash at beginning of year2019-12-31$110,837
Total non interest bearing cash at beginning of year2019-12-31$110,837
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$58,158
Value of net income/loss2019-12-31$58,158
Value of net assets at end of year (total assets less liabilities)2019-12-31$168,995
Value of net assets at end of year (total assets less liabilities)2019-12-31$168,995
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$110,837
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$110,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$12
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$12
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$857,512
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$857,512
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contract administrator fees2019-12-31$98,446
Contract administrator fees2019-12-31$98,446
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm name2019-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2019-12-31010523282
Accountancy firm EIN2019-12-31010523282
2018 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$829,411
Total of all expenses incurred2018-12-31$818,001
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$680,037
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$796,573
Value of total assets at end of year2018-12-31$110,837
Value of total assets at beginning of year2018-12-31$99,427
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$137,964
Total interest from all sources2018-12-31$65
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$22,666
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$300,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$796,573
Other income not declared elsewhere2018-12-31$32,773
Administrative expenses (other) incurred2018-12-31$11,367
Total non interest bearing cash at end of year2018-12-31$110,837
Total non interest bearing cash at beginning of year2018-12-31$89,320
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$11,410
Value of net assets at end of year (total assets less liabilities)2018-12-31$110,837
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$99,427
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$10,107
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$10,107
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$65
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$680,037
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contract administrator fees2018-12-31$103,931
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2018-12-31010523282
2017 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$435,452
Total of all expenses incurred2017-12-31$454,365
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$348,691
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$435,327
Value of total assets at end of year2017-12-31$99,427
Value of total assets at beginning of year2017-12-31$118,340
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$105,674
Total interest from all sources2017-12-31$125
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$33,088
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$300,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$435,327
Administrative expenses (other) incurred2017-12-31$17,118
Total non interest bearing cash at end of year2017-12-31$89,320
Total non interest bearing cash at beginning of year2017-12-31$32,119
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-18,913
Value of net assets at end of year (total assets less liabilities)2017-12-31$99,427
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$118,340
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$10,107
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$86,221
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$86,221
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$125
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$348,691
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contract administrator fees2017-12-31$55,468
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BERRY DUNN MCNEIL & PARKER
Accountancy firm EIN2017-12-31010523282
2016 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$448,220
Total of all expenses incurred2016-12-31$420,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$342,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$448,053
Value of total assets at end of year2016-12-31$118,340
Value of total assets at beginning of year2016-12-31$90,960
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$77,970
Total interest from all sources2016-12-31$167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$16,270
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$300,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$448,053
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$2,754
Administrative expenses (other) incurred2016-12-31$12,600
Total non interest bearing cash at end of year2016-12-31$32,119
Total non interest bearing cash at beginning of year2016-12-31$4,906
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$27,380
Value of net assets at end of year (total assets less liabilities)2016-12-31$118,340
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$90,960
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$86,221
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$86,054
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$86,054
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$167
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$340,116
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contract administrator fees2016-12-31$49,100
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BROOKS & BROOKS CPAS
Accountancy firm EIN2016-12-31010447753
2015 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$356,572
Total of all expenses incurred2015-12-31$371,939
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$288,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$356,233
Value of total assets at end of year2015-12-31$90,960
Value of total assets at beginning of year2015-12-31$106,327
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$83,672
Total interest from all sources2015-12-31$339
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$9,995
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$300,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$356,233
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$2,862
Administrative expenses (other) incurred2015-12-31$12,277
Total non interest bearing cash at end of year2015-12-31$4,906
Total non interest bearing cash at beginning of year2015-12-31$2,804
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-15,367
Value of net assets at end of year (total assets less liabilities)2015-12-31$90,960
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$106,327
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$86,054
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$103,523
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$103,523
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$339
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$285,405
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contract administrator fees2015-12-31$61,400
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BROOKS & BROOKS CPAS
Accountancy firm EIN2015-12-31010447753
2014 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$376,503
Total of all expenses incurred2014-12-31$404,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$315,883
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$376,008
Value of total assets at end of year2014-12-31$106,327
Value of total assets at beginning of year2014-12-31$134,310
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$88,603
Total interest from all sources2014-12-31$495
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$5,000
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$300,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$376,008
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$3,240
Administrative expenses (other) incurred2014-12-31$13,603
Total non interest bearing cash at end of year2014-12-31$2,804
Total non interest bearing cash at beginning of year2014-12-31$1,364
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-27,983
Value of net assets at end of year (total assets less liabilities)2014-12-31$106,327
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$134,310
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$103,523
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$132,946
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$132,946
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$495
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$312,643
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contract administrator fees2014-12-31$70,000
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BROOKS & BROOKS CPAS
Accountancy firm EIN2014-12-31010447753
2013 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$389,250
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$416,582
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$324,118
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$388,626
Value of total assets at end of year2013-12-31$134,311
Value of total assets at beginning of year2013-12-31$161,643
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$92,464
Total interest from all sources2013-12-31$624
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$8,688
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$10,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$388,626
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$3,344
Administrative expenses (other) incurred2013-12-31$35,776
Total non interest bearing cash at end of year2013-12-31$1,364
Total non interest bearing cash at beginning of year2013-12-31$29,321
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-27,332
Value of net assets at end of year (total assets less liabilities)2013-12-31$134,311
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$161,643
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$132,947
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$132,322
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$132,322
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$624
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$324,118
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contract administrator fees2013-12-31$48,000
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31LARRY L CAMPBELL
Accountancy firm EIN2013-12-31320308855
2012 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$406,686
Total of all expenses incurred2012-12-31$438,263
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$346,256
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$405,802
Value of total assets at end of year2012-12-31$163,763
Value of total assets at beginning of year2012-12-31$195,341
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$92,007
Total interest from all sources2012-12-31$884
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$405,802
Administrative expenses (other) incurred2012-12-31$70,007
Total non interest bearing cash at end of year2012-12-31$29,582
Total non interest bearing cash at beginning of year2012-12-31$20,928
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-31,577
Value of net assets at end of year (total assets less liabilities)2012-12-31$163,763
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$195,341
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$132,347
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$173,739
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$173,739
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$884
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$346,256
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contract administrator fees2012-12-31$22,000
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$1,834
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$674
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31LARRY L. CAMPBELL, C.P.A.
Accountancy firm EIN2012-12-31320308855
2011 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$433,485
Total of all expenses incurred2011-12-31$449,871
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$360,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$431,814
Value of total assets at end of year2011-12-31$195,341
Value of total assets at beginning of year2011-12-31$214,087
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$89,553
Total interest from all sources2011-12-31$1,671
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$431,814
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$4,285
Administrative expenses (other) incurred2011-12-31$67,553
Total non interest bearing cash at end of year2011-12-31$20,928
Total non interest bearing cash at beginning of year2011-12-31$38,242
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-16,386
Value of net assets at end of year (total assets less liabilities)2011-12-31$195,341
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$214,087
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$173,739
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$172,754
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$172,754
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,671
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$356,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contract administrator fees2011-12-31$22,000
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$674
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$3,091
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31LARRY L CAMPBELL, CPA
Accountancy firm EIN2011-12-31320308855
2010 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$490,342
Total of all expenses incurred2010-12-31$474,247
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$379,313
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$488,220
Value of total assets at end of year2010-12-31$214,087
Value of total assets at beginning of year2010-12-31$198,727
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$94,934
Total interest from all sources2010-12-31$2,122
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$488,220
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$30,032
Administrative expenses (other) incurred2010-12-31$72,934
Total non interest bearing cash at end of year2010-12-31$38,242
Total non interest bearing cash at beginning of year2010-12-31$22,628
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$16,095
Value of net assets at end of year (total assets less liabilities)2010-12-31$214,087
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$198,727
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$172,754
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$171,386
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$171,386
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$2,122
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$349,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contract administrator fees2010-12-31$22,000
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$3,091
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$4,713
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31LARRY L. CAMPBELL, CPA
Accountancy firm EIN2010-12-31320308855

Form 5500 Responses for AFSCME MAINE MEMBERSHIP BENEFIT FUND

2021: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Submission has been amendedYes
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2009: AFSCME MAINE MEMBERSHIP BENEFIT FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176831001
Policy instance 4
Insurance contract or identification number10176831001
Number of Individuals Covered88
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $898
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $898
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4978821
Policy instance 3
Insurance contract or identification numberE4978821
Number of Individuals Covered528
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $78,417
Total amount of fees paid to insurance companyUSD $6,559
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $784,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,052
Amount paid for insurance broker fees722
Additional information about fees paid to insurance brokerBONSUSES AND NON-CASH INCENTIVES
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 2
Insurance contract or identification number000006752
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $209
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 1
Insurance contract or identification numberMLN00514
Number of Individuals Covered20
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $842
Total amount of fees paid to insurance companyUSD $400
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $842
Insurance broker organization code?3
Amount paid for insurance broker fees400
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 1
Insurance contract or identification numberMLN00514
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $868
Total amount of fees paid to insurance companyUSD $411
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $868
Insurance broker organization code?3
Amount paid for insurance broker fees411
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 2
Insurance contract or identification number000006752
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $381
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $303
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4978821
Policy instance 3
Insurance contract or identification numberE4978821
Number of Individuals Covered627
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $104,184
Total amount of fees paid to insurance companyUSD $15,418
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $833,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,126
Amount paid for insurance broker fees10224
Additional information about fees paid to insurance brokerBONUSES AND NON-CASH INCENTIVES
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176831001
Policy instance 4
Insurance contract or identification number10176831001
Number of Individuals Covered110
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $835
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $835
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6090562
Policy instance 5
Insurance contract or identification number6090562
Number of Individuals Covered14
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $309
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $309
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6090562
Policy instance 5
Insurance contract or identification number6090562
Number of Individuals Covered14
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $277
Total amount of fees paid to insurance companyUSD $7
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $277
Amount paid for insurance broker fees7
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176831001
Policy instance 4
Insurance contract or identification number10176831001
Number of Individuals Covered125
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $948
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $948
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4978821
Policy instance 3
Insurance contract or identification numberE4978821
Number of Individuals Covered691
Insurance policy start date2019-04-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $311,478
Total amount of fees paid to insurance companyUSD $132,287
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $904,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153,572
Amount paid for insurance broker fees53519
Additional information about fees paid to insurance brokerBONUSES AND NON-CASH INCENTIVES
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 2
Insurance contract or identification number000006752
Number of Individuals Covered9
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $373
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $297
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 1
Insurance contract or identification numberMLN00514
Number of Individuals Covered20
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $840
Total amount of fees paid to insurance companyUSD $398
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $840
Insurance broker organization code?3
Amount paid for insurance broker fees398
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4978821
Policy instance 6
Insurance contract or identification numberE4978821
Number of Individuals Covered712
Insurance policy start date2018-04-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $238,454
Total amount of fees paid to insurance companyUSD $110,343
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $430,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $115,008
Insurance broker organization code?3
Amount paid for insurance broker fees52242
Additional information about fees paid to insurance brokerBONUSES AND NON-CASH INCENTIVES
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 5
Insurance contract or identification numberE3021185
Number of Individuals Covered168
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $4,655
Total amount of fees paid to insurance companyUSD $721
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $25,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,330
Amount paid for insurance broker fees129
Additional information about fees paid to insurance brokerBONUSES AND NON-CASH INCENTIVES
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6090562
Policy instance 4
Insurance contract or identification number6090562
Number of Individuals Covered12
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $275
Total amount of fees paid to insurance companyUSD $7
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $275
Amount paid for insurance broker fees7
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 3
Insurance contract or identification number000006752
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $604
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $481
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 2
Insurance contract or identification number615977
Number of Individuals Covered45
Insurance policy start date2018-01-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $371
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $371
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 1
Insurance contract or identification numberMLN00514
Number of Individuals Covered21
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,050
Total amount of fees paid to insurance companyUSD $497
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees497
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,050
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001744
Policy instance 7
Insurance contract or identification number001744
Number of Individuals Covered145
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $4,590
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,590
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001766
Policy instance 13
Insurance contract or identification number001766
Number of Individuals Covered41
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $1,065
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,065
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001765
Policy instance 8
Insurance contract or identification number001765
Number of Individuals Covered12
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $281
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $281
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10176831001
Policy instance 19
Insurance contract or identification number10176831001
Number of Individuals Covered124
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $283
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $283
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001755
Policy instance 17
Insurance contract or identification number001755
Number of Individuals Covered8
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $130
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $130
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001764
Policy instance 18
Insurance contract or identification number001764
Number of Individuals Covered9
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $209
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $209
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001759
Policy instance 16
Insurance contract or identification number001759
Number of Individuals Covered9
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $261
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001760
Policy instance 15
Insurance contract or identification number001760
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $350
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $350
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001758
Policy instance 14
Insurance contract or identification number001758
Number of Individuals Covered36
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $475
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $475
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001757
Policy instance 12
Insurance contract or identification number001757
Number of Individuals Covered27
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $674
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $674
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001756
Policy instance 10
Insurance contract or identification number001756
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $242
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $242
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001743
Policy instance 11
Insurance contract or identification number001743
Number of Individuals Covered24
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $733
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $733
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number001745
Policy instance 9
Insurance contract or identification number001745
Number of Individuals Covered17
Insurance policy start date2018-01-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $437
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $437
Insurance broker organization code?3
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27751
Policy instance 14
Insurance contract or identification numberY27751
Number of Individuals Covered20
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,603
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $8,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,603
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27795
Policy instance 15
Insurance contract or identification numberY27795
Number of Individuals Covered12
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,031
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,031
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY28048
Policy instance 16
Insurance contract or identification numberY28048
Number of Individuals Covered149
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $19,018
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $95,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,018
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY15011
Policy instance 17
Insurance contract or identification numberY15011
Number of Individuals Covered9
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $919
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $919
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27413
Policy instance 18
Insurance contract or identification numberY27413
Number of Individuals Covered25
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $3,161
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $15,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,161
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 19
Insurance contract or identification numberE3021185
Number of Individuals Covered174
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,383
Total amount of fees paid to insurance companyUSD $8,681
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $105,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,117
Amount paid for insurance broker fees409
Additional information about fees paid to insurance brokerBONUSES AND NON-CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameCOAKLEY CONSULTING INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 2
Insurance contract or identification number615977
Number of Individuals Covered57
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $907
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $907
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27478
Policy instance 13
Insurance contract or identification numberY27478
Number of Individuals Covered10
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $983
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $983
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27440
Policy instance 12
Insurance contract or identification numberY27440
Number of Individuals Covered27
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $2,561
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,561
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 1
Insurance contract or identification numberMLN00514
Number of Individuals Covered34
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,656
Total amount of fees paid to insurance companyUSD $795
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,656
Insurance broker organization code?3
Amount paid for insurance broker fees795
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameCOMBINED SERVICES, LLC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 3
Insurance contract or identification number000006752
Number of Individuals Covered15
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $416
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $331
Insurance broker organization code?3
Insurance broker nameCOMBINED SERVICES, LLC
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6090562
Policy instance 4
Insurance contract or identification number6090562
Number of Individuals Covered13
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $299
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedPREPAID LEGAL
Welfare Benefit Premiums Paid to CarrierUSD $2,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $299
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY15402
Policy instance 5
Insurance contract or identification numberY15402
Number of Individuals Covered50
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $5,849
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $29,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,849
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY15467
Policy instance 6
Insurance contract or identification numberY15467
Number of Individuals Covered9
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,002
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,002
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY16131
Policy instance 7
Insurance contract or identification numberY16131
Number of Individuals Covered10
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $676
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $676
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY16200
Policy instance 8
Insurance contract or identification numberY16200
Number of Individuals Covered16
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,695
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $8,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,695
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY16550
Policy instance 9
Insurance contract or identification numberY16550
Number of Individuals Covered36
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $1,913
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,913
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY16619
Policy instance 10
Insurance contract or identification numberY16619
Number of Individuals Covered49
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $4,956
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,956
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY27094
Policy instance 11
Insurance contract or identification numberY27094
Number of Individuals Covered26
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $2,430
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,430
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 1
Insurance contract or identification number000006752
Number of Individuals Covered13
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $685
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $546
Insurance broker organization code?3
Insurance broker nameCOMBINED SERVICES LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 3
Insurance contract or identification number615977
Number of Individuals Covered73
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,178
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,178
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 4
Insurance contract or identification numberE3021185
Number of Individuals Covered12
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $678
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $297
Insurance broker organization code?3
Insurance broker nameLISA MARIE FULLER
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY28048
Policy instance 5
Insurance contract or identification numberY28048
Number of Individuals Covered503
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $53,764
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,060
Insurance broker organization code?3
Insurance broker nameKEVIN M WHITE
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 2
Insurance contract or identification numberMLN00514
Number of Individuals Covered35
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,743
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,662
Insurance broker organization code?3
Insurance broker nameCOMBINED SERVICES LLC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 1
Insurance contract or identification number000006752
Number of Individuals Covered12
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $850
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $674
Insurance broker organization code?3
Insurance broker nameCOMBINED SERVICES LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 2
Insurance contract or identification numberMLN00514
Number of Individuals Covered39
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,903
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,652
Insurance broker organization code?3
Insurance broker nameCOMBINED SERVICES LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number694426
Policy instance 3
Insurance contract or identification number694426
Number of Individuals Covered549
Insurance policy start date2014-01-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $16,491
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,491
Insurance broker organization code?3
Insurance broker nameKEVIN WHITE
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 4
Insurance contract or identification number615977
Number of Individuals Covered71
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,475
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,475
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP INC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 5
Insurance contract or identification numberE3021185
Number of Individuals Covered15
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $239
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $239
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )
Policy contract numberY28048
Policy instance 6
Insurance contract or identification numberY28048
Number of Individuals Covered499
Insurance policy start date2014-05-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $36,619
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,915
Insurance broker organization code?3
Insurance broker nameKEVIN WHITE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 5
Insurance contract or identification numberE3021185
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $244
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $244
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFIT TRUST INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 4
Insurance contract or identification number615977
Number of Individuals Covered88
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,698
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number694426
Policy instance 3
Insurance contract or identification number694426
Number of Individuals Covered590
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $50,564
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLNOO514
Policy instance 2
Insurance contract or identification numberMLNOO514
Number of Individuals Covered55
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,705
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 1
Insurance contract or identification number000006752
Number of Individuals Covered8
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,560
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Welfare Benefit Premiums Paid to CarrierUSD $11,461
Commission paid to Insurance BrokerUSD $1,307
Insurance broker organization code?3
Insurance broker nameKEVIN WHITE MEMBERSHIP BENEFITS
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number615977
Policy instance 2
Insurance contract or identification number615977
Number of Individuals Covered88
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,698
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $13,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,698
Insurance broker organization code?3
Insurance broker nameMEMBERSHIP BENEFITS GROUP INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLNOO514
Policy instance 3
Insurance contract or identification numberMLNOO514
Number of Individuals Covered55
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,705
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $9,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,705
Insurance broker nameKEVIN WHITE MEMBERSHIP BENEFITS
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number694426
Policy instance 4
Insurance contract or identification number694426
Number of Individuals Covered590
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $50,564
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $266,204
Commission paid to Insurance BrokerUSD $50,564
Insurance broker nameKEVIN WHITE MEMBERSHIP BENEFITS
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 2
Insurance contract or identification numberMLN00514
Number of Individuals Covered55
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,696
Commission paid to Insurance BrokerUSD $2,696
Additional information about fees paid to insurance brokerLIFE INSURANCE
Insurance broker organization code?3
Insurance broker nameKEVIN G WHITE
AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 )
Policy contract number30790-1163
Policy instance 1
Insurance contract or identification number30790-1163
Number of Individuals Covered32
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $425
Commission paid to Insurance BrokerUSD $425
Additional information about fees paid to insurance brokerDISABILITY
Insurance broker organization code?3
Insurance broker nameKEVIN G WHITE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number694426
Policy instance 3
Insurance contract or identification number694426
Number of Individuals Covered594
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $53,874
Commission paid to Insurance BrokerUSD $53,874
Additional information about fees paid to insurance brokerLIFE AND ACCIDENT INSURANCE
Insurance broker organization code?3
Insurance broker nameKEVIN G WHITE
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 4
Insurance contract or identification number000006752
Number of Individuals Covered22
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,992
Commission paid to Insurance BrokerUSD $1,992
Additional information about fees paid to insurance brokerDENTAL INSURANCE
Insurance broker organization code?3
Insurance broker nameKEVIN G. WHITE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 5
Insurance contract or identification numberE3021185
Number of Individuals Covered8
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $269
Commission paid to Insurance BrokerUSD $269
Additional information about fees paid to insurance brokerSICKNESS, CANCER, LIFE, ACCIDENT AND DISABILITY INSURANCE
Insurance broker organization code?3
Insurance broker nameKEVIN G WHITE
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMLN00514
Policy instance 2
Insurance contract or identification numberMLN00514
Number of Individuals Covered60
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,727
Life Insurance Welfare BenefitYes
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number694426
Policy instance 3
Insurance contract or identification number694426
Number of Individuals Covered592
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $52,230
Life Insurance Welfare BenefitYes
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006752
Policy instance 4
Insurance contract or identification number000006752
Number of Individuals Covered22
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,263
Dental Insurance Welfare BenefitYes
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3021185
Policy instance 5
Insurance contract or identification numberE3021185
Number of Individuals Covered45
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $836
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 )
Policy contract number30790-1163
Policy instance 1
Insurance contract or identification number30790-1163
Number of Individuals Covered63
Insurance policy start date2010-01-10
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $768
Vision Insurance Welfare BenefitYes

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