POMEROY ELECTRIC INCORPORATED has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2022: POMEROY INC WELFARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-03-01 | 216 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 195 |
Number of retired or separated participants receiving benefits | 2022-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-03-01 | 0 |
Total of all active and inactive participants | 2022-03-01 | 195 |
2021: POMEROY INC WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-03-01 | 216 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 216 |
Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 0 |
Total of all active and inactive participants | 2021-03-01 | 216 |
2020: POMEROY INC WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-03-01 | 226 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 226 |
Number of retired or separated participants receiving benefits | 2020-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
Total of all active and inactive participants | 2020-03-01 | 226 |
2019: POMEROY INC WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-03-01 | 231 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 226 |
Number of retired or separated participants receiving benefits | 2019-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 0 |
Total of all active and inactive participants | 2019-03-01 | 226 |
2018: POMEROY INC WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-03-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 231 |
Number of retired or separated participants receiving benefits | 2018-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-03-01 | 0 |
Total of all active and inactive participants | 2018-03-01 | 231 |
2017: POMEROY INC WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-03-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 231 |
Number of retired or separated participants receiving benefits | 2017-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
Total of all active and inactive participants | 2017-03-01 | 231 |
2016: POMEROY INC WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-03-01 | 232 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 199 |
Number of retired or separated participants receiving benefits | 2016-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 0 |
Total of all active and inactive participants | 2016-03-01 | 199 |
2015: POMEROY INC WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-03-01 | 232 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 232 |
Number of retired or separated participants receiving benefits | 2015-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-03-01 | 0 |
Total of all active and inactive participants | 2015-03-01 | 232 |
2013: POMEROY INC WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-03-01 | 300 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 334 |
Total of all active and inactive participants | 2013-03-01 | 334 |
Total participants | 2013-03-01 | 334 |
2012: POMEROY INC WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-03-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 300 |
Total of all active and inactive participants | 2012-03-01 | 300 |
Total participants | 2012-03-01 | 300 |
2011: POMEROY INC WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-03-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 135 |
Total of all active and inactive participants | 2011-03-01 | 135 |
Total participants | 2011-03-01 | 135 |
2009: POMEROY INC WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-03-01 | 182 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 103 |
Total of all active and inactive participants | 2009-03-01 | 103 |
Total participants | 2009-03-01 | 103 |
Measure | Date | Value |
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2023 : POMEROY INC WELFARE PLAN 2023 401k financial data |
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Total income from all sources | 2023-02-28 | $0 |
Total plan assets at end of year | 2023-02-28 | $0 |
Total plan assets at beginning of year | 2023-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2023-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2023-02-28 | $0 |
2022 : POMEROY INC WELFARE PLAN 2022 401k financial data |
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Total income from all sources | 2022-02-28 | $0 |
Total plan assets at end of year | 2022-02-28 | $0 |
Total plan assets at beginning of year | 2022-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2022-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2022-02-28 | $0 |
2021 : POMEROY INC WELFARE PLAN 2021 401k financial data |
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Total income from all sources | 2021-02-28 | $0 |
Total plan assets at end of year | 2021-02-28 | $0 |
Total plan assets at beginning of year | 2021-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2021-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2021-02-28 | $0 |
2020 : POMEROY INC WELFARE PLAN 2020 401k financial data |
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Total income from all sources | 2020-02-29 | $0 |
Total plan assets at end of year | 2020-02-29 | $0 |
Total plan assets at beginning of year | 2020-02-29 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2020-02-29 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2020-02-29 | $0 |
2019 : POMEROY INC WELFARE PLAN 2019 401k financial data |
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Total income from all sources | 2019-02-28 | $0 |
Total plan assets at end of year | 2019-02-28 | $0 |
Total plan assets at beginning of year | 2019-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2019-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2019-02-28 | $0 |
2018 : POMEROY INC WELFARE PLAN 2018 401k financial data |
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Total income from all sources | 2018-02-28 | $0 |
Total plan assets at end of year | 2018-02-28 | $0 |
Total plan assets at beginning of year | 2018-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2018-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2018-02-28 | $0 |
2017 : POMEROY INC WELFARE PLAN 2017 401k financial data |
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Total income from all sources | 2017-02-28 | $0 |
Total plan assets at end of year | 2017-02-28 | $0 |
Total plan assets at beginning of year | 2017-02-28 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2017-02-28 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2017-02-28 | $0 |
2016 : POMEROY INC WELFARE PLAN 2016 401k financial data |
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Total income from all sources | 2016-02-29 | $0 |
Total plan assets at end of year | 2016-02-29 | $0 |
Total plan assets at beginning of year | 2016-02-29 | $0 |
Net plan assets at end of year (total assets less liabilities) | 2016-02-29 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2016-02-29 | $0 |
2022: POMEROY INC WELFARE PLAN 2022 form 5500 responses |
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2022-03-01 | Type of plan entity | Single employer plan |
2022-03-01 | Plan funding arrangement – Insurance | Yes |
2022-03-01 | Plan benefit arrangement – Insurance | Yes |
2021: POMEROY INC WELFARE PLAN 2021 form 5500 responses |
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2021-03-01 | Type of plan entity | Single employer plan |
2021-03-01 | Plan funding arrangement – Insurance | Yes |
2021-03-01 | Plan benefit arrangement – Insurance | Yes |
2020: POMEROY INC WELFARE PLAN 2020 form 5500 responses |
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2020-03-01 | Type of plan entity | Single employer plan |
2020-03-01 | Plan funding arrangement – Insurance | Yes |
2020-03-01 | Plan benefit arrangement – Insurance | Yes |
2019: POMEROY INC WELFARE PLAN 2019 form 5500 responses |
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2019-03-01 | Type of plan entity | Single employer plan |
2019-03-01 | Plan funding arrangement – Insurance | Yes |
2019-03-01 | Plan benefit arrangement – Insurance | Yes |
2018: POMEROY INC WELFARE PLAN 2018 form 5500 responses |
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2018-03-01 | Type of plan entity | Single employer plan |
2018-03-01 | Plan funding arrangement – Insurance | Yes |
2018-03-01 | Plan benefit arrangement – Insurance | Yes |
2017: POMEROY INC WELFARE PLAN 2017 form 5500 responses |
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2017-03-01 | Type of plan entity | Single employer plan |
2017-03-01 | Plan funding arrangement – Insurance | Yes |
2017-03-01 | Plan benefit arrangement – Insurance | Yes |
2016: POMEROY INC WELFARE PLAN 2016 form 5500 responses |
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2016-03-01 | Type of plan entity | Single employer plan |
2016-03-01 | Plan funding arrangement – Insurance | Yes |
2016-03-01 | Plan benefit arrangement – Insurance | Yes |
2015: POMEROY INC WELFARE PLAN 2015 form 5500 responses |
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2015-03-01 | Type of plan entity | Single employer plan |
2015-03-01 | Submission has been amended | Yes |
2015-03-01 | Plan funding arrangement – Insurance | Yes |
2015-03-01 | Plan benefit arrangement – Insurance | Yes |
2013: POMEROY INC WELFARE PLAN 2013 form 5500 responses |
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2013-03-01 | Type of plan entity | Single employer plan |
2013-03-01 | Submission has been amended | No |
2013-03-01 | This submission is the final filing | No |
2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-03-01 | Plan is a collectively bargained plan | No |
2013-03-01 | Plan funding arrangement – Insurance | Yes |
2013-03-01 | Plan benefit arrangement – Insurance | Yes |
2012: POMEROY INC WELFARE PLAN 2012 form 5500 responses |
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2012-03-01 | Type of plan entity | Single employer plan |
2012-03-01 | Submission has been amended | No |
2012-03-01 | This submission is the final filing | No |
2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-03-01 | Plan is a collectively bargained plan | No |
2012-03-01 | Plan funding arrangement – Insurance | Yes |
2012-03-01 | Plan benefit arrangement – Insurance | Yes |
2011: POMEROY INC WELFARE PLAN 2011 form 5500 responses |
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2011-03-01 | Type of plan entity | Single employer plan |
2011-03-01 | Submission has been amended | No |
2011-03-01 | This submission is the final filing | No |
2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-03-01 | Plan is a collectively bargained plan | No |
2011-03-01 | Plan funding arrangement – Insurance | Yes |
2011-03-01 | Plan benefit arrangement – Insurance | Yes |
2009: POMEROY INC WELFARE PLAN 2009 form 5500 responses |
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2009-03-01 | Type of plan entity | Single employer plan |
2009-03-01 | Submission has been amended | No |
2009-03-01 | This submission is the final filing | No |
2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-03-01 | Plan is a collectively bargained plan | No |
2009-03-01 | Plan funding arrangement – Insurance | Yes |
2009-03-01 | Plan benefit arrangement – Insurance | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05950943 |
Policy instance | 2 |
Insurance contract or identification number | TM05950943 | Number of Individuals Covered | 195 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2023-02-28 | Total amount of commissions paid to insurance broker | USD $5,562 | Total amount of fees paid to insurance company | USD $685 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) - ADD | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,562 | Amount paid for insurance broker fees | 594 | Additional information about fees paid to insurance broker | COMMSSION | Insurance broker organization code? | 3 |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 1 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 165 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2023-02-28 | Total amount of commissions paid to insurance broker | USD $9,780 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,770 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 0629147 |
Policy instance | 3 |
Insurance contract or identification number | 0629147 | Number of Individuals Covered | 111 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2023-02-28 | Total amount of commissions paid to insurance broker | USD $50,168 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,168 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00629147 |
Policy instance | 3 |
Insurance contract or identification number | 00629147 | Number of Individuals Covered | 122 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $54,722 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $54,722 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5950943 |
Policy instance | 2 |
Insurance contract or identification number | 5950943 | Number of Individuals Covered | 216 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $5,232 | Total amount of fees paid to insurance company | USD $492 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) - ADD | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,232 | Amount paid for insurance broker fees | 31 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 1 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 185 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $3,619 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,698 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5950943 |
Policy instance | 2 |
Insurance contract or identification number | 5950943 | Number of Individuals Covered | 216 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $5,232 | Total amount of fees paid to insurance company | USD $492 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) - ADD | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,232 | Amount paid for insurance broker fees | 31 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
|
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 1 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 185 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $2,458 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,467 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00629147 |
Policy instance | 3 |
Insurance contract or identification number | 00629147 | Number of Individuals Covered | 122 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $54,722 | Total amount of fees paid to insurance company | USD $77 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $54,722 | Amount paid for insurance broker fees | 77 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 0629147 |
Policy instance | 4 |
Insurance contract or identification number | 0629147 | Number of Individuals Covered | 117 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $5,889 | Total amount of fees paid to insurance company | USD $77 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,889 | Amount paid for insurance broker fees | 77 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
Policy contract number | 29975 |
Policy instance | 4 |
Insurance contract or identification number | 29975 | Number of Individuals Covered | 40 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $1,122 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,122 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
Policy contract number | X5606-X576K8 |
Policy instance | 5 |
Insurance contract or identification number | X5606-X576K8 | Number of Individuals Covered | 67 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $3,685 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,685 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
|
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 3 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 176 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $13,692 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,672 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
Policy contract number | D0242 |
Policy instance | 2 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 103 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $52,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,164 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
Policy contract number | D0242 |
Policy instance | 1 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 11 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $6,866 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,866 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05950943 |
Policy instance | 6 |
Insurance contract or identification number | TM05950943 | Number of Individuals Covered | 216 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $5,237 | Total amount of fees paid to insurance company | USD $641 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) - ADD | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,237 | Amount paid for insurance broker fees | 641 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05950943 |
Policy instance | 6 |
Insurance contract or identification number | TM05950943 | Number of Individuals Covered | 216 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $3,320 | Total amount of fees paid to insurance company | USD $501 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) - ADD | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,320 | Amount paid for insurance broker fees | 501 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
Policy contract number | D0242 |
Policy instance | 1 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 11 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $2,784 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,784 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
Policy contract number | D0242 |
Policy instance | 2 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 103 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $41,969 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,969 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 3 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 176 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $6,559 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,598 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
Policy contract number | 29975 |
Policy instance | 4 |
Insurance contract or identification number | 29975 | Number of Individuals Covered | 40 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $1,261 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,212 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
Policy contract number | X5606-X576K8 |
Policy instance | 5 |
Insurance contract or identification number | X5606-X576K8 | Number of Individuals Covered | 67 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $4,023 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,023 | Additional information about fees paid to insurance broker | COMMSSIONS | Insurance broker organization code? | 3 |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 690287 |
Policy instance | 3 |
Insurance contract or identification number | 690287 | Number of Individuals Covered | 139 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $4,426 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,425 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY ACENTRIA INSURANCE |
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BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
Policy contract number | D0242 |
Policy instance | 2 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 231 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $54,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $54,780 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES NA |
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BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
Policy contract number | D0242 |
Policy instance | 1 |
Insurance contract or identification number | D0242 | Number of Individuals Covered | 8 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $3,385 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,385 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES NA |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 1 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 232 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $7,993 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,381 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | INSURANCE OFFICE OF AMERICA |
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COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
Policy contract number | 690287 |
Policy instance | 2 |
Insurance contract or identification number | 690287 | Number of Individuals Covered | 79 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $2,494 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $-6 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY ACENTRIA INSURANCE |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 690287 |
Policy instance | 3 |
Insurance contract or identification number | 690287 | Number of Individuals Covered | 54 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $5,858 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY ACENTRIA INSURANCE |
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HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
Policy contract number | 690287 |
Policy instance | 4 |
Insurance contract or identification number | 690287 | Number of Individuals Covered | 132 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $70,379 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $247 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY ACENTRIA INSURANCE |
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COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
Policy contract number | 6041800000 |
Policy instance | 1 |
Insurance contract or identification number | 6041800000 | Number of Individuals Covered | 334 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $65,564 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,311,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $65,564 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | DAVID D STANTON |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00475938 |
Policy instance | 2 |
Insurance contract or identification number | 00475938 | Number of Individuals Covered | 160 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $7,479 | Total amount of fees paid to insurance company | USD $2,050 | 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 | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | 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 $103,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,479 | Amount paid for insurance broker fees | 2050 | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY INSURANCE AGCY LC |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 3 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 186 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $11,443 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | 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 | Yes | 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 $124,432 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $879 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | AMERICAN FIDELITY ASSURANCE COMPANY |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00475938 |
Policy instance | 2 |
Insurance contract or identification number | 00475938 | Number of Individuals Covered | 135 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $6,978 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | 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 $88,020 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,978 | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY INSURANCE AGCY LC |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 3 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 142 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $9,385 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $111,791 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,045 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | INS OFFICE OF AMERICA |
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COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
Policy contract number | 6041800000 |
Policy instance | 1 |
Insurance contract or identification number | 6041800000 | Number of Individuals Covered | 300 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $63,789 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,063,143 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63,789 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | DAVID D. STANTON |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3208188 |
Policy instance | 1 |
Insurance contract or identification number | 3208188 | Number of Individuals Covered | 120 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $4,217 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | 91498 |
Policy instance | 4 |
Insurance contract or identification number | 91498 | Number of Individuals Covered | 104 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $6,226 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $105,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COVENTRY HEALTH CARE OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 95114 ) |
Policy contract number | 6041800000 |
Policy instance | 3 |
Insurance contract or identification number | 6041800000 | Number of Individuals Covered | 126 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $77,064 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,196,180 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX960113 |
Policy instance | 2 |
Insurance contract or identification number | FLX960113 | Number of Individuals Covered | 135 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $3,000 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACC. DEATH & DISMEMB. | Welfare Benefit Premiums Paid to Carrier | USD $19,997 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | CANCER |
Policy instance | 4 |
Insurance contract or identification number | CANCER | Number of Individuals Covered | 16 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $420 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,374 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $420 | Insurance broker name | GATEWAY INSURANCE AGENCY |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | STD |
Policy instance | 7 |
Insurance contract or identification number | STD | Number of Individuals Covered | 7 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $348 | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $5,586 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $295 | Insurance broker name | INS OFFICE OF AMERICA |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | LTD |
Policy instance | 6 |
Insurance contract or identification number | LTD | Number of Individuals Covered | 63 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2010-02-28 | Total amount of commissions paid to insurance broker | USD $3,644 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,567 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,040 | Insurance broker name | INS OFFICE OF AMERICA |
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HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
Policy contract number | 711554 |
Policy instance | 1 |
Insurance contract or identification number | 711554 | Number of Individuals Covered | 135 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $40,520 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,520 | Insurance broker name | GATEWAY INSURANCE AGENCY LC |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | INDIVIDUAL HI |
Policy instance | 5 |
Insurance contract or identification number | INDIVIDUAL HI | Number of Individuals Covered | 41 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $904 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,037 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 904 | Insurance broker name | GATEWAY INSURANCE AGENCY |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX960113 |
Policy instance | 3 |
Insurance contract or identification number | FLX960113 | Number of Individuals Covered | 131 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $2,852 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $19,013 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,852 | Insurance broker name | GATEWAY INSURANCE AGENCY |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3208188 |
Policy instance | 2 |
Insurance contract or identification number | 3208188 | Number of Individuals Covered | 131 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $3,781 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,781 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | Insurance broker organization code? | 3 | Insurance broker name | GATEWAY INSURANCE AGENCY LC |
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