401k Plan data: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN plan

EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN
Plan identification number	502

EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

EXETER GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: EXETER GROUP, INC.

Employer identification number (EIN): 042810147

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Additional information about EXETER GROUP, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1995-11-16

Company Identification Number: P95000088201

Legal Registered Office Address: 1201 HAYS STREET

TALLAHASSEE

32301

More information about EXETER GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2015-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2016-07-27
502 2015-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2016-07-27
502 2014-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2015-10-14
502 2013-01-01 PHILIP L CIFARELLI PHILIP L CIFARELLI 2014-10-15
502 2012-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2013-10-13
502 2011-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2012-10-12
502 2009-01-01 PHILIP L. CIFARELLI PHILIP L. CIFARELLI 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2015-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2016-07-27
502	2015-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2016-07-27
502	2014-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2015-10-14
502	2013-01-01	PHILIP L CIFARELLI	PHILIP L CIFARELLI	2014-10-15
502	2012-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2013-10-13
502	2011-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2012-10-12
502	2009-01-01	PHILIP L. CIFARELLI	PHILIP L. CIFARELLI	2010-10-15

Plan Statistics for EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2015: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 8
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 8
Total participants 2015-01-01 8
2014: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 163
Number of retired or separated participants receiving benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 164
Total participants 2014-01-01 164
2013: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 195
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 196
Total participants 2013-01-01 196
2012: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 170
Number of retired or separated participants receiving benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 170
Total participants 2012-01-01 170
2011: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 132
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 132
Total participants 2011-01-01 132
2009: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 123
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 125
Total participants 2009-01-01 125

Measure	Date	Value
2015: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	8
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	8
Total participants	2015-01-01	8
2014: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	163
Number of retired or separated participants receiving benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	164
Total participants	2014-01-01	164
2013: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	195
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	196
Total participants	2013-01-01	196
2012: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	170
Number of retired or separated participants receiving benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	170
Total participants	2012-01-01	170
2011: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	132
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	132
Total participants	2011-01-01	132
2009: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	123
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	125
Total participants	2009-01-01	125

Form 5500 Responses for EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN

2015: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	This submission is the final filing	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EXETER GROUP, INC. HEALTH & WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	98
Insurance policy start date	2014-10-01
Insurance policy end date	2015-10-01
Total amount of commissions paid to insurance broker	USD $2,018
Total amount of fees paid to insurance company	USD $794
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,018
Amount paid for insurance broker fees	794
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	98
Insurance policy start date	2014-10-01
Insurance policy end date	2015-10-01
Total amount of commissions paid to insurance broker	USD $3,162
Total amount of fees paid to insurance company	USD $928
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,162
Amount paid for insurance broker fees	928
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	54
Insurance policy start date	2015-02-01
Insurance policy end date	2016-01-31
Total amount of commissions paid to insurance broker	USD $16,497
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $543,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,497
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	98
Insurance policy start date	2014-10-01
Insurance policy end date	2015-10-01
Total amount of commissions paid to insurance broker	USD $1,889
Total amount of fees paid to insurance company	USD $753
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,889
Amount paid for insurance broker fees	753
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	22
Insurance policy start date	2014-10-01
Insurance policy end date	2015-10-01
Total amount of commissions paid to insurance broker	USD $1,033
Total amount of fees paid to insurance company	USD $323
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,033
Amount paid for insurance broker fees	323
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	57
Insurance policy start date	2015-02-01
Insurance policy end date	2016-01-31
Total amount of commissions paid to insurance broker	USD $3,155
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $55,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,155
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	8
Insurance policy start date	2015-10-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $133
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $133
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	8
Insurance policy start date	2015-10-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $62
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $62
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	8
Insurance policy start date	2015-10-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $254
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $254
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	8
Insurance policy start date	2015-10-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $139
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $139
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES (NY) LLC

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	162
Insurance policy start date	2014-02-01
Insurance policy end date	2015-01-31
Total amount of commissions paid to insurance broker	USD $20,133
Total amount of fees paid to insurance company	USD $9,586
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $702,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $20,133
Amount paid for insurance broker fees	9586
Additional information about fees paid to insurance broker	OTHER COMMISSION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	110
Insurance policy start date	2013-10-01
Insurance policy end date	2014-10-01
Total amount of commissions paid to insurance broker	USD $3,342
Total amount of fees paid to insurance company	USD $1,680
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,342
Amount paid for insurance broker fees	1680
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	110
Insurance policy start date	2013-10-01
Insurance policy end date	2014-10-01
Total amount of commissions paid to insurance broker	USD $2,212
Total amount of fees paid to insurance company	USD $1,428
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,212
Amount paid for insurance broker fees	1428
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	110
Insurance policy start date	2013-10-01
Insurance policy end date	2014-10-01
Total amount of commissions paid to insurance broker	USD $2,316
Total amount of fees paid to insurance company	USD $1,508
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,316
Amount paid for insurance broker fees	1508
Additional information about fees paid to insurance broker	AGENT OF BROKER OF RECORD OTHER COMPENSATION 3
Insurance broker name	NFP CORPORATE SERVICES

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	164
Insurance policy start date	2014-02-01
Insurance policy end date	2015-01-31
Total amount of commissions paid to insurance broker	USD $3,957
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $74,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,957
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	30
Insurance policy start date	2013-10-01
Insurance policy end date	2014-10-01
Total amount of commissions paid to insurance broker	USD $1,458
Total amount of fees paid to insurance company	USD $562
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,458
Amount paid for insurance broker fees	562
Additional information about fees paid to insurance broker	AGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	132
Insurance policy start date	2012-10-01
Insurance policy end date	2013-10-01
Total amount of commissions paid to insurance broker	USD $2,416
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,643
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL INS AGENCY

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	193
Insurance policy start date	2013-02-01
Insurance policy end date	2014-01-31
Total amount of commissions paid to insurance broker	USD $21,707
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $771,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,707
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	195
Insurance policy start date	2013-02-01
Insurance policy end date	2014-01-31
Total amount of commissions paid to insurance broker	USD $3,963
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $76,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,963
Insurance broker organization code?	3
Insurance broker name	NFP CORPORATE SERVICES

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	132
Insurance policy start date	2012-10-01
Insurance policy end date	2013-10-01
Total amount of commissions paid to insurance broker	USD $2,523
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,714
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL INS AGENCY

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	132
Insurance policy start date	2012-10-01
Insurance policy end date	2013-10-01
Total amount of commissions paid to insurance broker	USD $3,391
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,060
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL INS AGENCY

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	37
Insurance policy start date	2012-10-01
Insurance policy end date	2013-10-01
Total amount of commissions paid to insurance broker	USD $1,365
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $904
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL INS AGENCY

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	121
Insurance policy start date	2011-10-01
Insurance policy end date	2012-10-01
Total amount of commissions paid to insurance broker	USD $1,961
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,961
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	121
Insurance policy start date	2011-10-01
Insurance policy end date	2012-10-01
Total amount of commissions paid to insurance broker	USD $3,054
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,054
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	121
Insurance policy start date	2011-10-01
Insurance policy end date	2012-10-01
Total amount of commissions paid to insurance broker	USD $2,076
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,076
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	168
Insurance policy start date	2012-02-01
Insurance policy end date	2013-01-31
Total amount of commissions paid to insurance broker	USD $36,986
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $629,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $2,777
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	170
Insurance policy start date	2012-02-01
Insurance policy end date	2013-01-31
Total amount of commissions paid to insurance broker	USD $7,114
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $453
Insurance broker organization code?	3
Insurance broker name	PARTNER FINANCIAL

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	35
Insurance policy start date	2011-10-01
Insurance policy end date	2012-10-01
Total amount of commissions paid to insurance broker	USD $1,268
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,268
Insurance broker organization code?	3
Insurance broker name	PARTNERS FINANCIAL

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	132
Insurance policy start date	2011-02-01
Insurance policy end date	2012-01-31
Total amount of commissions paid to insurance broker	USD $2,837
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $49,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	130
Insurance policy start date	2011-02-01
Insurance policy end date	2012-01-31
Total amount of commissions paid to insurance broker	USD $14,416
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $486,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AH72

Policy instance

Insurance contract or identification number	GUG0AH72
Number of Individuals Covered	84
Insurance policy start date	2010-10-01
Insurance policy end date	2011-10-01
Total amount of commissions paid to insurance broker	USD $1,940
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AH72

Policy instance

Insurance contract or identification number	GLTD0AH72
Number of Individuals Covered	84
Insurance policy start date	2010-10-01
Insurance policy end date	2011-10-01
Total amount of commissions paid to insurance broker	USD $2,922
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0AH72

Policy instance

Insurance contract or identification number	GLUG0AH72
Number of Individuals Covered	84
Insurance policy start date	2010-10-01
Insurance policy end date	2011-10-01
Total amount of commissions paid to insurance broker	USD $1,823
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GVTL0AH72

Policy instance

Insurance contract or identification number	GVTL0AH72
Number of Individuals Covered	28
Insurance policy start date	2010-10-01
Insurance policy end date	2011-10-01
Total amount of commissions paid to insurance broker	USD $873
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	117
Insurance policy start date	2010-02-01
Insurance policy end date	2011-01-31
Total amount of commissions paid to insurance broker	USD $2,563
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )

Policy contract number

4000624

Policy instance

Insurance contract or identification number	4000624
Number of Individuals Covered	116
Insurance policy start date	2010-02-01
Insurance policy end date	2011-01-31
Total amount of commissions paid to insurance broker	USD $13,667
Total amount of fees paid to insurance company	USD $325
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $467,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

007871

Policy instance

Insurance contract or identification number	007871
Number of Individuals Covered	64
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $2,547
Total amount of fees paid to insurance company	USD $119
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

007871

Policy instance

Insurance contract or identification number	007871
Number of Individuals Covered	64
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $1,619
Total amount of fees paid to insurance company	USD $134
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

007871

Policy instance

Insurance contract or identification number	007871
Number of Individuals Covered	64
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $1,393
Total amount of fees paid to insurance company	USD $99
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EXETER GROUP, INC.
Employer identification number (EIN):	042810147
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1995-11-16
Company Identification Number:	P95000088201
Legal Registered Office Address:	1201 HAYS STREET TALLAHASSEE 32301