AFSCME COUNCIL 93 has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AFSCME MAINE MEMBERSHIP BENEFIT FUND
Measure | Date | Value |
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2021 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2021 401k financial data |
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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 incurred | 2021-12-31 | $949,540 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $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 year | 2021-12-31 | $25 |
Value of total assets at beginning of year | 2021-12-31 | $181,633 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $125,490 |
Total interest from all sources | 2021-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
Administrative expenses professional fees incurred | 2021-12-31 | $23,200 |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $300,000 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $682,214 |
Other income not declared elsewhere | 2021-12-31 | $85,718 |
Administrative expenses (other) incurred | 2021-12-31 | $10,040 |
Liabilities. Value of operating payables at end of year | 2021-12-31 | $25 |
Total non interest bearing cash at end of year | 2021-12-31 | $25 |
Total non interest bearing cash at beginning of year | 2021-12-31 | $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 appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $-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) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $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 benefits | 2021-12-31 | $824,050 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contract administrator fees | 2021-12-31 | $92,250 |
Did the plan have assets held for investment | 2021-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm EIN | 2021-12-31 | 010523282 |
2020 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2020 401k financial data |
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Total income from all sources (including contributions) | 2020-12-31 | $1,031,367 |
Total of all expenses incurred | 2020-12-31 | $1,018,729 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $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 year | 2020-12-31 | $181,633 |
Value of total assets at beginning of year | 2020-12-31 | $168,995 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $120,003 |
Total interest from all sources | 2020-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
Administrative expenses professional fees incurred | 2020-12-31 | $16,148 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $300,000 |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $941,874 |
Other income not declared elsewhere | 2020-12-31 | $89,493 |
Administrative expenses (other) incurred | 2020-12-31 | $9,028 |
Total non interest bearing cash at end of year | 2020-12-31 | $181,633 |
Total non interest bearing cash at beginning of year | 2020-12-31 | $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 appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $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) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $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 benefits | 2020-12-31 | $898,726 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contract administrator fees | 2020-12-31 | $94,827 |
Did the plan have assets held for investment | 2020-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm EIN | 2020-12-31 | 010523282 |
2019 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2019 401k financial data |
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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 incurred | 2019-12-31 | $983,716 |
Total of all expenses incurred | 2019-12-31 | $983,716 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $857,512 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $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 year | 2019-12-31 | $168,995 |
Value of total assets at end of year | 2019-12-31 | $168,995 |
Value of total assets at beginning of year | 2019-12-31 | $110,837 |
Value of total assets at beginning of year | 2019-12-31 | $110,837 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $126,204 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $126,204 |
Total interest from all sources | 2019-12-31 | $12 |
Total interest from all sources | 2019-12-31 | $12 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Administrative expenses professional fees incurred | 2019-12-31 | $10,421 |
Administrative expenses professional fees incurred | 2019-12-31 | $10,421 |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $300,000 |
Value of fidelity bond cover | 2019-12-31 | $300,000 |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $980,649 |
Contributions received from participants | 2019-12-31 | $980,649 |
Other income not declared elsewhere | 2019-12-31 | $61,213 |
Other income not declared elsewhere | 2019-12-31 | $61,213 |
Administrative expenses (other) incurred | 2019-12-31 | $17,337 |
Administrative expenses (other) incurred | 2019-12-31 | $17,337 |
Total non interest bearing cash at end of year | 2019-12-31 | $168,995 |
Total non interest bearing cash at end of year | 2019-12-31 | $168,995 |
Total non interest bearing cash at beginning of year | 2019-12-31 | $110,837 |
Total non interest bearing cash at beginning of year | 2019-12-31 | $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 appraiser | 2019-12-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $58,158 |
Value of net income/loss | 2019-12-31 | $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) | 2019-12-31 | No |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $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 benefits | 2019-12-31 | $857,512 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $857,512 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contract administrator fees | 2019-12-31 | $98,446 |
Contract administrator fees | 2019-12-31 | $98,446 |
Did the plan have assets held for investment | 2019-12-31 | No |
Did the plan have assets held for investment | 2019-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Accountancy firm name | 2019-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm name | 2019-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm EIN | 2019-12-31 | 010523282 |
Accountancy firm EIN | 2019-12-31 | 010523282 |
2018 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2018 401k financial data |
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Total income from all sources (including contributions) | 2018-12-31 | $829,411 |
Total of all expenses incurred | 2018-12-31 | $818,001 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $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 year | 2018-12-31 | $110,837 |
Value of total assets at beginning of year | 2018-12-31 | $99,427 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $137,964 |
Total interest from all sources | 2018-12-31 | $65 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
Administrative expenses professional fees incurred | 2018-12-31 | $22,666 |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $300,000 |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Contributions received from participants | 2018-12-31 | $796,573 |
Other income not declared elsewhere | 2018-12-31 | $32,773 |
Administrative expenses (other) incurred | 2018-12-31 | $11,367 |
Total non interest bearing cash at end of year | 2018-12-31 | $110,837 |
Total non interest bearing cash at beginning of year | 2018-12-31 | $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 appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $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) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $10,107 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $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 benefits | 2018-12-31 | $680,037 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contract administrator fees | 2018-12-31 | $103,931 |
Did the plan have assets held for investment | 2018-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
Accountancy firm name | 2018-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm EIN | 2018-12-31 | 010523282 |
2017 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2017 401k financial data |
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Total income from all sources (including contributions) | 2017-12-31 | $435,452 |
Total of all expenses incurred | 2017-12-31 | $454,365 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $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 year | 2017-12-31 | $99,427 |
Value of total assets at beginning of year | 2017-12-31 | $118,340 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $105,674 |
Total interest from all sources | 2017-12-31 | $125 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Administrative expenses professional fees incurred | 2017-12-31 | $33,088 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $300,000 |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Contributions received from participants | 2017-12-31 | $435,327 |
Administrative expenses (other) incurred | 2017-12-31 | $17,118 |
Total non interest bearing cash at end of year | 2017-12-31 | $89,320 |
Total non interest bearing cash at beginning of year | 2017-12-31 | $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 appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $-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) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $10,107 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $86,221 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $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 benefits | 2017-12-31 | $348,691 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contract administrator fees | 2017-12-31 | $55,468 |
Did the plan have assets held for investment | 2017-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
Accountancy firm name | 2017-12-31 | BERRY DUNN MCNEIL & PARKER |
Accountancy firm EIN | 2017-12-31 | 010523282 |
2016 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2016 401k financial data |
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Total income from all sources (including contributions) | 2016-12-31 | $448,220 |
Total of all expenses incurred | 2016-12-31 | $420,840 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $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 year | 2016-12-31 | $118,340 |
Value of total assets at beginning of year | 2016-12-31 | $90,960 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $77,970 |
Total interest from all sources | 2016-12-31 | $167 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Administrative expenses professional fees incurred | 2016-12-31 | $16,270 |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $300,000 |
If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Contributions received from participants | 2016-12-31 | $448,053 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $2,754 |
Administrative expenses (other) incurred | 2016-12-31 | $12,600 |
Total non interest bearing cash at end of year | 2016-12-31 | $32,119 |
Total non interest bearing cash at beginning of year | 2016-12-31 | $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 appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $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) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Value of interest in common/collective trusts at end of year | 2016-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $86,221 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $86,054 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $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 benefits | 2016-12-31 | $340,116 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Contract administrator fees | 2016-12-31 | $49,100 |
Did the plan have assets held for investment | 2016-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
Accountancy firm name | 2016-12-31 | BROOKS & BROOKS CPAS |
Accountancy firm EIN | 2016-12-31 | 010447753 |
2015 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2015 401k financial data |
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Total income from all sources (including contributions) | 2015-12-31 | $356,572 |
Total of all expenses incurred | 2015-12-31 | $371,939 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $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 year | 2015-12-31 | $90,960 |
Value of total assets at beginning of year | 2015-12-31 | $106,327 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $83,672 |
Total interest from all sources | 2015-12-31 | $339 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Administrative expenses professional fees incurred | 2015-12-31 | $9,995 |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $300,000 |
If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $356,233 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-12-31 | $2,862 |
Administrative expenses (other) incurred | 2015-12-31 | $12,277 |
Total non interest bearing cash at end of year | 2015-12-31 | $4,906 |
Total non interest bearing cash at beginning of year | 2015-12-31 | $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 appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $-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) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Value of interest in common/collective trusts at end of year | 2015-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $86,054 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $103,523 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $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 benefits | 2015-12-31 | $285,405 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Contract administrator fees | 2015-12-31 | $61,400 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
Accountancy firm name | 2015-12-31 | BROOKS & BROOKS CPAS |
Accountancy firm EIN | 2015-12-31 | 010447753 |
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 incurred | 2014-12-31 | $404,486 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $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 year | 2014-12-31 | $106,327 |
Value of total assets at beginning of year | 2014-12-31 | $134,310 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $88,603 |
Total interest from all sources | 2014-12-31 | $495 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Administrative expenses professional fees incurred | 2014-12-31 | $5,000 |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $300,000 |
If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $376,008 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-12-31 | $3,240 |
Administrative expenses (other) incurred | 2014-12-31 | $13,603 |
Total non interest bearing cash at end of year | 2014-12-31 | $2,804 |
Total non interest bearing cash at beginning of year | 2014-12-31 | $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 appraiser | 2014-12-31 | No |
Value of net income/loss | 2014-12-31 | $-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) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Value of interest in common/collective trusts at end of year | 2014-12-31 | $0 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $103,523 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $132,946 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $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 benefits | 2014-12-31 | $312,643 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Contract administrator fees | 2014-12-31 | $70,000 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
Accountancy firm name | 2014-12-31 | BROOKS & BROOKS CPAS |
Accountancy firm EIN | 2014-12-31 | 010447753 |
2013 : AFSCME MAINE MEMBERSHIP BENEFIT FUND 2013 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2013-12-31 | $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 assets | 2013-12-31 | $0 |
Total of all expenses incurred | 2013-12-31 | $416,582 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $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 year | 2013-12-31 | $134,311 |
Value of total assets at beginning of year | 2013-12-31 | $161,643 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $92,464 |
Total interest from all sources | 2013-12-31 | $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 year | 2013-12-31 | No |
Administrative expenses professional fees incurred | 2013-12-31 | $8,688 |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $10,000 |
If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $388,626 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-12-31 | $3,344 |
Administrative expenses (other) incurred | 2013-12-31 | $35,776 |
Total non interest bearing cash at end of year | 2013-12-31 | $1,364 |
Total non interest bearing cash at beginning of year | 2013-12-31 | $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 appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $-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) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $132,947 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $132,322 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $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 benefits | 2013-12-31 | $324,118 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contract administrator fees | 2013-12-31 | $48,000 |
Did the plan have assets held for investment | 2013-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
Accountancy firm name | 2013-12-31 | LARRY L CAMPBELL |
Accountancy firm EIN | 2013-12-31 | 320308855 |
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 incurred | 2012-12-31 | $438,263 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $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 year | 2012-12-31 | $163,763 |
Value of total assets at beginning of year | 2012-12-31 | $195,341 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $92,007 |
Total interest from all sources | 2012-12-31 | $884 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $10,000 |
If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $405,802 |
Administrative expenses (other) incurred | 2012-12-31 | $70,007 |
Total non interest bearing cash at end of year | 2012-12-31 | $29,582 |
Total non interest bearing cash at beginning of year | 2012-12-31 | $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 appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $-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) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $132,347 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $173,739 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $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 benefits | 2012-12-31 | $346,256 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contract administrator fees | 2012-12-31 | $22,000 |
Assets. Value of buildings and other operty used in plan operation at end of year | 2012-12-31 | $1,834 |
Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-12-31 | $674 |
Did the plan have assets held for investment | 2012-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
Accountancy firm name | 2012-12-31 | LARRY L. CAMPBELL, C.P.A. |
Accountancy firm EIN | 2012-12-31 | 320308855 |
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 incurred | 2011-12-31 | $449,871 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $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 year | 2011-12-31 | $195,341 |
Value of total assets at beginning of year | 2011-12-31 | $214,087 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $89,553 |
Total interest from all sources | 2011-12-31 | $1,671 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $10,000 |
If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $431,814 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-12-31 | $4,285 |
Administrative expenses (other) incurred | 2011-12-31 | $67,553 |
Total non interest bearing cash at end of year | 2011-12-31 | $20,928 |
Total non interest bearing cash at beginning of year | 2011-12-31 | $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 appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $-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) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $173,739 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $172,754 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $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 benefits | 2011-12-31 | $356,033 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contract administrator fees | 2011-12-31 | $22,000 |
Assets. Value of buildings and other operty used in plan operation at end of year | 2011-12-31 | $674 |
Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-12-31 | $3,091 |
Did the plan have assets held for investment | 2011-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
Accountancy firm name | 2011-12-31 | LARRY L CAMPBELL, CPA |
Accountancy firm EIN | 2011-12-31 | 320308855 |
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 incurred | 2010-12-31 | $474,247 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $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 year | 2010-12-31 | $214,087 |
Value of total assets at beginning of year | 2010-12-31 | $198,727 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $94,934 |
Total interest from all sources | 2010-12-31 | $2,122 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $10,000 |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $488,220 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2010-12-31 | $30,032 |
Administrative expenses (other) incurred | 2010-12-31 | $72,934 |
Total non interest bearing cash at end of year | 2010-12-31 | $38,242 |
Total non interest bearing cash at beginning of year | 2010-12-31 | $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 appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $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) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $172,754 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $171,386 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $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 benefits | 2010-12-31 | $349,281 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contract administrator fees | 2010-12-31 | $22,000 |
Assets. Value of buildings and other operty used in plan operation at end of year | 2010-12-31 | $3,091 |
Assets. Value of buildings and other operty used in plan operation at beginning of year | 2010-12-31 | $4,713 |
Did the plan have assets held for investment | 2010-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
Accountancy firm name | 2010-12-31 | LARRY L. CAMPBELL, CPA |
Accountancy firm EIN | 2010-12-31 | 320308855 |
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10176831001 |
Policy instance | 4 |
Insurance contract or identification number | 10176831001 | Number of Individuals Covered | 88 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $898 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,450 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $898 | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4978821 |
Policy instance | 3 |
Insurance contract or identification number | E4978821 | Number of Individuals Covered | 528 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $78,417 | Total amount of fees paid to insurance company | USD $6,559 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $784,457 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,052 | Amount paid for insurance broker fees | 722 | Additional information about fees paid to insurance broker | BONSUSES 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 number | 000006752 |
Policy instance | 2 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 6 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $263 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $209 | Insurance broker organization code? | 3 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 1 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 20 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $842 | Total amount of fees paid to insurance company | USD $400 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,367 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $842 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 400 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 1 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 20 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $868 | Total amount of fees paid to insurance company | USD $411 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $868 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 411 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
|
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 2 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 9 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $381 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,710 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $303 | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4978821 |
Policy instance | 3 |
Insurance contract or identification number | E4978821 | Number of Individuals Covered | 627 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $104,184 | Total amount of fees paid to insurance company | USD $15,418 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $833,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $60,126 | Amount paid for insurance broker fees | 10224 | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10176831001 |
Policy instance | 4 |
Insurance contract or identification number | 10176831001 | Number of Individuals Covered | 110 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $835 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $835 | Insurance broker organization code? | 3 |
|
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090562 |
Policy instance | 5 |
Insurance contract or identification number | 6090562 | Number of Individuals Covered | 14 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $309 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $2,844 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $309 | Insurance broker organization code? | 3 |
|
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090562 |
Policy instance | 5 |
Insurance contract or identification number | 6090562 | Number of Individuals Covered | 14 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $277 | Total amount of fees paid to insurance company | USD $7 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $2,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $277 | Amount paid for insurance broker fees | 7 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10176831001 |
Policy instance | 4 |
Insurance contract or identification number | 10176831001 | Number of Individuals Covered | 125 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $948 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,467 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $948 | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4978821 |
Policy instance | 3 |
Insurance contract or identification number | E4978821 | Number of Individuals Covered | 691 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $311,478 | Total amount of fees paid to insurance company | USD $132,287 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $904,560 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $153,572 | Amount paid for insurance broker fees | 53519 | Additional information about fees paid to insurance broker | BONUSES 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 number | 000006752 |
Policy instance | 2 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 9 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $373 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,898 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $297 | Insurance broker organization code? | 3 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 1 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 20 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $840 | Total amount of fees paid to insurance company | USD $398 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $840 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 398 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4978821 |
Policy instance | 6 |
Insurance contract or identification number | E4978821 | Number of Individuals Covered | 712 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $238,454 | Total amount of fees paid to insurance company | USD $110,343 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $430,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $115,008 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 52242 | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 5 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 168 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $4,655 | Total amount of fees paid to insurance company | USD $721 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $25,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,330 | Amount paid for insurance broker fees | 129 | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | Insurance broker organization code? | 3 |
|
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090562 |
Policy instance | 4 |
Insurance contract or identification number | 6090562 | Number of Individuals Covered | 12 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $275 | Total amount of fees paid to insurance company | USD $7 | Other welfare benefits provided | PREPAID LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $2,988 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $275 | Amount paid for insurance broker fees | 7 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 3 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $604 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,448 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $481 | Insurance broker organization code? | 3 |
|
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 2 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 45 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $371 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $371 | Insurance broker organization code? | 3 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 1 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 21 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,050 | Total amount of fees paid to insurance company | USD $497 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 497 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $1,050 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001744 |
Policy instance | 7 |
Insurance contract or identification number | 001744 | Number of Individuals Covered | 145 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $4,590 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,503 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,590 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001766 |
Policy instance | 13 |
Insurance contract or identification number | 001766 | Number of Individuals Covered | 41 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $1,065 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,065 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001765 |
Policy instance | 8 |
Insurance contract or identification number | 001765 | Number of Individuals Covered | 12 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $281 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $951 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $281 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10176831001 |
Policy instance | 19 |
Insurance contract or identification number | 10176831001 | Number of Individuals Covered | 124 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $283 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,618 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $283 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001755 |
Policy instance | 17 |
Insurance contract or identification number | 001755 | Number of Individuals Covered | 8 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $130 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $433 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $130 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001764 |
Policy instance | 18 |
Insurance contract or identification number | 001764 | Number of Individuals Covered | 9 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $209 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $696 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $209 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001759 |
Policy instance | 16 |
Insurance contract or identification number | 001759 | Number of Individuals Covered | 9 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $261 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $871 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $261 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001760 |
Policy instance | 15 |
Insurance contract or identification number | 001760 | Number of Individuals Covered | 16 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $350 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,167 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $350 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001758 |
Policy instance | 14 |
Insurance contract or identification number | 001758 | Number of Individuals Covered | 36 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $475 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,583 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $475 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001757 |
Policy instance | 12 |
Insurance contract or identification number | 001757 | Number of Individuals Covered | 27 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $674 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,267 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $674 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001756 |
Policy instance | 10 |
Insurance contract or identification number | 001756 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $242 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $242 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001743 |
Policy instance | 11 |
Insurance contract or identification number | 001743 | Number of Individuals Covered | 24 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $733 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $733 | Insurance broker organization code? | 3 |
|
MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
Policy contract number | 001745 |
Policy instance | 9 |
Insurance contract or identification number | 001745 | Number of Individuals Covered | 17 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $437 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,457 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $437 | Insurance broker organization code? | 3 |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27751 |
Policy instance | 14 |
Insurance contract or identification number | Y27751 | Number of Individuals Covered | 20 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $1,603 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,017 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,603 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27795 |
Policy instance | 15 |
Insurance contract or identification number | Y27795 | Number of Individuals Covered | 12 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $1,031 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,154 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,031 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y28048 |
Policy instance | 16 |
Insurance contract or identification number | Y28048 | Number of Individuals Covered | 149 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $19,018 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $95,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,018 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y15011 |
Policy instance | 17 |
Insurance contract or identification number | Y15011 | Number of Individuals Covered | 9 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $919 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,594 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $919 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27413 |
Policy instance | 18 |
Insurance contract or identification number | Y27413 | Number of Individuals Covered | 25 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $3,161 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $15,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,161 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 19 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 174 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $25,383 | Total amount of fees paid to insurance company | USD $8,681 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $105,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,117 | Amount paid for insurance broker fees | 409 | Additional information about fees paid to insurance broker | BONUSES AND NON-CASH INCENTIVES | Insurance broker organization code? | 3 | Insurance broker name | COAKLEY CONSULTING INC |
|
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 2 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 57 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $907 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,070 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $907 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27478 |
Policy instance | 13 |
Insurance contract or identification number | Y27478 | Number of Individuals Covered | 10 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $983 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $983 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27440 |
Policy instance | 12 |
Insurance contract or identification number | Y27440 | Number of Individuals Covered | 27 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $2,561 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $12,806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,561 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 1 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 34 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,656 | Total amount of fees paid to insurance company | USD $795 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,656 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 795 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker name | COMBINED SERVICES, LLC |
|
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 3 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 15 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $416 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,406 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $331 | Insurance broker organization code? | 3 | Insurance broker name | COMBINED SERVICES, LLC |
|
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090562 |
Policy instance | 4 |
Insurance contract or identification number | 6090562 | Number of Individuals Covered | 13 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $299 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | PREPAID LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $2,754 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $299 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y15402 |
Policy instance | 5 |
Insurance contract or identification number | Y15402 | Number of Individuals Covered | 50 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $5,849 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $29,244 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,849 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y15467 |
Policy instance | 6 |
Insurance contract or identification number | Y15467 | Number of Individuals Covered | 9 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $1,002 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,010 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,002 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y16131 |
Policy instance | 7 |
Insurance contract or identification number | Y16131 | Number of Individuals Covered | 10 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $676 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $3,381 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $676 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y16200 |
Policy instance | 8 |
Insurance contract or identification number | Y16200 | Number of Individuals Covered | 16 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $1,695 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,477 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,695 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y16550 |
Policy instance | 9 |
Insurance contract or identification number | Y16550 | Number of Individuals Covered | 36 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $1,913 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $9,564 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,913 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y16619 |
Policy instance | 10 |
Insurance contract or identification number | Y16619 | Number of Individuals Covered | 49 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $4,956 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $24,779 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,956 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y27094 |
Policy instance | 11 |
Insurance contract or identification number | Y27094 | Number of Individuals Covered | 26 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $2,430 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $12,149 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,430 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 1 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 13 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $685 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $546 | Insurance broker organization code? | 3 | Insurance broker name | COMBINED SERVICES LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 3 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 73 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,178 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,580 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,178 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 4 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 12 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $678 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,466 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $297 | Insurance broker organization code? | 3 | Insurance broker name | LISA MARIE FULLER |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y28048 |
Policy instance | 5 |
Insurance contract or identification number | Y28048 | Number of Individuals Covered | 503 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $53,764 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $268,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,060 | Insurance broker organization code? | 3 | Insurance broker name | KEVIN M WHITE |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 2 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 35 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,743 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,662 | Insurance broker organization code? | 3 | Insurance broker name | COMBINED SERVICES LLC |
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DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 1 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 12 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $850 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $674 | Insurance broker organization code? | 3 | Insurance broker name | COMBINED SERVICES LLC |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 2 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 39 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,903 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,511 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,652 | Insurance broker organization code? | 3 | Insurance broker name | COMBINED SERVICES LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 694426 |
Policy instance | 3 |
Insurance contract or identification number | 694426 | Number of Individuals Covered | 549 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $16,491 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,406 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,491 | Insurance broker organization code? | 3 | Insurance broker name | KEVIN WHITE |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 4 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 71 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,475 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,475 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP INC |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 5 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 15 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $239 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,612 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $239 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | Y28048 |
Policy instance | 6 |
Insurance contract or identification number | Y28048 | Number of Individuals Covered | 499 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $36,619 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $204,652 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,915 | Insurance broker organization code? | 3 | Insurance broker name | KEVIN WHITE |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 5 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 8 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Broker | USD $244 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFIT TRUST INC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 4 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 88 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 694426 |
Policy instance | 3 |
Insurance contract or identification number | 694426 | Number of Individuals Covered | 590 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLNOO514 |
Policy instance | 2 |
Insurance contract or identification number | MLNOO514 | Number of Individuals Covered | 55 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 1 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 8 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $11,461 | Commission paid to Insurance Broker | USD $1,307 | Insurance broker organization code? | 3 | Insurance broker name | KEVIN WHITE MEMBERSHIP BENEFITS |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 615977 |
Policy instance | 2 |
Insurance contract or identification number | 615977 | Number of Individuals Covered | 88 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $13,352 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,698 | Insurance broker organization code? | 3 | Insurance broker name | MEMBERSHIP BENEFITS GROUP INC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLNOO514 |
Policy instance | 3 |
Insurance contract or identification number | MLNOO514 | Number of Individuals Covered | 55 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,705 | Insurance broker name | KEVIN WHITE MEMBERSHIP BENEFITS |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 694426 |
Policy instance | 4 |
Insurance contract or identification number | 694426 | Number of Individuals Covered | 590 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $266,204 | Commission paid to Insurance Broker | USD $50,564 | Insurance broker name | KEVIN WHITE MEMBERSHIP BENEFITS |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 2 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 55 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,696 | Commission paid to Insurance Broker | USD $2,696 | Additional information about fees paid to insurance broker | LIFE INSURANCE | Insurance broker organization code? | 3 | Insurance broker name | KEVIN G WHITE |
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AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
Policy contract number | 30790-1163 |
Policy instance | 1 |
Insurance contract or identification number | 30790-1163 | Number of Individuals Covered | 32 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $425 | Commission paid to Insurance Broker | USD $425 | Additional information about fees paid to insurance broker | DISABILITY | Insurance broker organization code? | 3 | Insurance broker name | KEVIN G WHITE |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 694426 |
Policy instance | 3 |
Insurance contract or identification number | 694426 | Number of Individuals Covered | 594 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $53,874 | Commission paid to Insurance Broker | USD $53,874 | Additional information about fees paid to insurance broker | LIFE AND ACCIDENT INSURANCE | Insurance broker organization code? | 3 | Insurance broker name | KEVIN G WHITE |
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DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 4 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 22 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,992 | Commission paid to Insurance Broker | USD $1,992 | Additional information about fees paid to insurance broker | DENTAL INSURANCE | Insurance broker organization code? | 3 | Insurance broker name | KEVIN G. WHITE |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 5 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 8 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $269 | Commission paid to Insurance Broker | USD $269 | Additional information about fees paid to insurance broker | SICKNESS, CANCER, LIFE, ACCIDENT AND DISABILITY INSURANCE | Insurance broker organization code? | 3 | Insurance broker name | KEVIN G WHITE |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MLN00514 |
Policy instance | 2 |
Insurance contract or identification number | MLN00514 | Number of Individuals Covered | 60 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,727 | Life Insurance Welfare Benefit | Yes |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 694426 |
Policy instance | 3 |
Insurance contract or identification number | 694426 | Number of Individuals Covered | 592 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $52,230 | Life Insurance Welfare Benefit | Yes |
|
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000006752 |
Policy instance | 4 |
Insurance contract or identification number | 000006752 | Number of Individuals Covered | 22 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,263 | Dental Insurance Welfare Benefit | Yes |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3021185 |
Policy instance | 5 |
Insurance contract or identification number | E3021185 | Number of Individuals Covered | 45 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $836 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes |
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AVESIS THIRD PARTY ADMINISTRATORS, INC. (National Association of Insurance Commissioners NAIC id number: 52413 ) |
Policy contract number | 30790-1163 |
Policy instance | 1 |
Insurance contract or identification number | 30790-1163 | Number of Individuals Covered | 63 | Insurance policy start date | 2010-01-10 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $768 | Vision Insurance Welfare Benefit | Yes |
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