STONE COAST FUND SERVICES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan STONE COAST FUND SERVICES LLC CONSOLIDATED WELFARE BENEFITS PLAN
401k plan membership statisitcs for STONE COAST FUND SERVICES LLC CONSOLIDATED WELFARE BENEFITS PLAN
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 000000619455 |
Policy instance | 12 |
Insurance contract or identification number | 000000619455 | Number of Individuals Covered | 50 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $948 | Total amount of fees paid to insurance company | USD $316 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $6,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $948 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 316 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135130 |
Policy instance | 1 |
Insurance contract or identification number | 135130 | Number of Individuals Covered | 212 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $7,907 | Total amount of fees paid to insurance company | USD $1,872 | 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 $102,199 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,907 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1872 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135131 |
Policy instance | 2 |
Insurance contract or identification number | 135131 | Number of Individuals Covered | 92 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $4,972 | Total amount of fees paid to insurance company | USD $663 | Other welfare benefits provided | VOLUNTARY LIFESTYLE ADD AND LIFE | Welfare Benefit Premiums Paid to Carrier | USD $33,145 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,972 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 663 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990000 |
Policy instance | 3 |
Insurance contract or identification number | 0874990000 | Number of Individuals Covered | 16 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $6,172 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $152,393 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,566 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062220000 |
Policy instance | 4 |
Insurance contract or identification number | 1062220000 | Number of Individuals Covered | 192 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $37,945 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $936,905 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,070 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062230000 |
Policy instance | 5 |
Insurance contract or identification number | 1062230000 | Number of Individuals Covered | 82 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $19,060 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $470,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,100 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990001 |
Policy instance | 6 |
Insurance contract or identification number | 0874990001 | Number of Individuals Covered | 2 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $468 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | COBRA | Welfare Benefit Premiums Paid to Carrier | USD $11,540 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $346 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 106222 |
Policy instance | 7 |
Insurance contract or identification number | 106222 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $18 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA/COBRA | Welfare Benefit Premiums Paid to Carrier | USD $437 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062230001 |
Policy instance | 8 |
Insurance contract or identification number | 1062230001 | Number of Individuals Covered | 2 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $630 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA/COBRA | Welfare Benefit Premiums Paid to Carrier | USD $15,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $466 | Insurance broker organization code? | 3 |
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DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
Policy contract number | 000060757 |
Policy instance | 9 |
Insurance contract or identification number | 000060757 | Number of Individuals Covered | 230 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $6,535 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $112,593 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,587 | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 619456 |
Policy instance | 10 |
Insurance contract or identification number | 619456 | Number of Individuals Covered | 20 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $709 | Total amount of fees paid to insurance company | USD $236 | Other welfare benefits provided | HOSPITAL EE PAID | Welfare Benefit Premiums Paid to Carrier | USD $5,141 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $709 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 236 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 000000619457 |
Policy instance | 11 |
Insurance contract or identification number | 000000619457 | Number of Individuals Covered | 36 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $662 | Total amount of fees paid to insurance company | USD $225 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,495 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $662 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 225 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135130 |
Policy instance | 1 |
Insurance contract or identification number | 135130 | Number of Individuals Covered | 378 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $8,887 | Total amount of fees paid to insurance company | USD $2,170 | 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 $108,493 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,887 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2170 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135131 |
Policy instance | 2 |
Insurance contract or identification number | 135131 | Number of Individuals Covered | 82 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $6,322 | Total amount of fees paid to insurance company | USD $843 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $42,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,322 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 843 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990000 |
Policy instance | 3 |
Insurance contract or identification number | 0874990000 | Number of Individuals Covered | 23 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $6,853 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $155,152 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,457 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062220000 |
Policy instance | 4 |
Insurance contract or identification number | 1062220000 | Number of Individuals Covered | 188 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $36,304 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $830,790 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,910 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062230000 |
Policy instance | 5 |
Insurance contract or identification number | 1062230000 | Number of Individuals Covered | 86 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $18,255 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $423,273 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,537 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990001 |
Policy instance | 6 |
Insurance contract or identification number | 0874990001 | Number of Individuals Covered | 2 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $177 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | COBRA | Welfare Benefit Premiums Paid to Carrier | USD $3,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $141 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062230000 |
Policy instance | 6 |
Insurance contract or identification number | 1062230000 | Number of Individuals Covered | 80 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $13,765 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $360,675 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,765 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062220000 |
Policy instance | 5 |
Insurance contract or identification number | 1062220000 | Number of Individuals Covered | 194 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $27,444 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | HSA | Welfare Benefit Premiums Paid to Carrier | USD $719,076 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,444 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 1062220001 |
Policy instance | 4 |
Insurance contract or identification number | 1062220001 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $75 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | COBRA | Welfare Benefit Premiums Paid to Carrier | USD $1,967 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $75 | Insurance broker organization code? | 3 |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990000 |
Policy instance | 3 |
Insurance contract or identification number | 0874990000 | Number of Individuals Covered | 14 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $4,156 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $108,903 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,156 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135131 |
Policy instance | 2 |
Insurance contract or identification number | 135131 | Number of Individuals Covered | 80 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $5,457 | Total amount of fees paid to insurance company | USD $728 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $36,383 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,457 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 728 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135130 |
Policy instance | 1 |
Insurance contract or identification number | 135130 | Number of Individuals Covered | 176 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $8,265 | Total amount of fees paid to insurance company | USD $2,013 | 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 $100,665 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,265 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2013 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135130 |
Policy instance | 1 |
Insurance contract or identification number | 135130 | Number of Individuals Covered | 187 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $8,600 | Total amount of fees paid to insurance company | USD $2,119 | 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 $105,930 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,600 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2119 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135131 |
Policy instance | 2 |
Insurance contract or identification number | 135131 | Number of Individuals Covered | 72 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $4,974 | Total amount of fees paid to insurance company | USD $663 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $33,161 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,974 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 663 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990000 |
Policy instance | 3 |
Insurance contract or identification number | 0874990000 | Number of Individuals Covered | 17 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $4,959 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $123,768 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,949 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0247480000 |
Policy instance | 4 |
Insurance contract or identification number | 0247480000 | Number of Individuals Covered | 88 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $13,525 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $341,139 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,498 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 02474800001 |
Policy instance | 5 |
Insurance contract or identification number | 02474800001 | Number of Individuals Covered | 3 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $713 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,037 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $712 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0431350000 |
Policy instance | 6 |
Insurance contract or identification number | 0431350000 | Number of Individuals Covered | 203 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $27,686 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $691,477 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,632 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0431350001 |
Policy instance | 7 |
Insurance contract or identification number | 0431350001 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $-55 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,123 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $-55 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135131 |
Policy instance | 2 |
Insurance contract or identification number | 135131 | Number of Individuals Covered | 70 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $4,487 | Total amount of fees paid to insurance company | USD $598 | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $32,197 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,304 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 494 | Additional information about fees paid to insurance broker | NONMONETARY COMPENSATION |
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HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
Policy contract number | 0874990000 |
Policy instance | 3 |
Insurance contract or identification number | 0874990000 | Number of Individuals Covered | 17 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $3,795 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $97,910 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,795 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0247480000 |
Policy instance | 4 |
Insurance contract or identification number | 0247480000 | Number of Individuals Covered | 78 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $11,896 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $306,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,896 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 02474800001 |
Policy instance | 5 |
Insurance contract or identification number | 02474800001 | Number of Individuals Covered | 3 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $503 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,968 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $503 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0431350000 |
Policy instance | 6 |
Insurance contract or identification number | 0431350000 | Number of Individuals Covered | 190 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $23,497 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $606,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,497 | Insurance broker organization code? | 3 |
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HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
Policy contract number | 0431350001 |
Policy instance | 7 |
Insurance contract or identification number | 0431350001 | Number of Individuals Covered | 6 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $745 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,227 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $745 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 135130 |
Policy instance | 1 |
Insurance contract or identification number | 135130 | Number of Individuals Covered | 150 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $4,382 | Total amount of fees paid to insurance company | USD $845 | 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 $45,967 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,393 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 693 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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