D & B ENGINEERS AND ARCHITECTS, D.P.C. has sponsored the creation of one or more 401k plans.
Additional information about D & B ENGINEERS AND ARCHITECTS, D.P.C.
Submission information for form 5500 for 401k plan D & B ENGINEERS AND ARCHITECTS, P.C. WELFARE BENEFIT PLAN
401k plan membership statisitcs for D & B ENGINEERS AND ARCHITECTS, P.C. WELFARE BENEFIT PLAN
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 3 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 149 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $2,442 | Total amount of fees paid to insurance company | USD $3,185 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,442 | Amount paid for insurance broker fees | 3185 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 908857 |
Policy instance | 2 |
Insurance contract or identification number | 908857 | Number of Individuals Covered | 252 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $130,012 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $2,760,062 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $116,311 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 1 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 149 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $3,329 | Total amount of fees paid to insurance company | USD $4,359 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,329 | Amount paid for insurance broker fees | 4359 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 2 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 2 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,107 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 264376 |
Policy instance | 1 |
Insurance contract or identification number | 264376 | Number of Individuals Covered | 242 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $109,651 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,741,269 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $109,651 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 520644 |
Policy instance | 3 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 3 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 257001-071 |
Policy instance | 4 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 14 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,490 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 908857 |
Policy instance | 5 |
Insurance contract or identification number | 908857 | Number of Individuals Covered | 205 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 153 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $3,571 | Total amount of fees paid to insurance company | USD $4,679 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,712 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,571 | Amount paid for insurance broker fees | 4679 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 520644 |
Policy instance | 7 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 5 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,777 | 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: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 153 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $2,597 | Total amount of fees paid to insurance company | USD $3,373 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $25,968 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,597 | Amount paid for insurance broker fees | 3373 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 1 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 2 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,671 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 520644 |
Policy instance | 2 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 194 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 4 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 173 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $4,152 | Total amount of fees paid to insurance company | USD $5,445 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,522 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,152 | Amount paid for insurance broker fees | 5445 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 257001-071 |
Policy instance | 3 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 13 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,490 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 520644 |
Policy instance | 5 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $49,091 | 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: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 173 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $2,926 | Total amount of fees paid to insurance company | USD $3,795 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $29,262 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,926 | Amount paid for insurance broker fees | 3795 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITED HEALTH CARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 264376 |
Policy instance | 7 |
Insurance contract or identification number | 264376 | Number of Individuals Covered | 273 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $107,430 | Total amount of fees paid to insurance company | USD $3,044 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $2,527,765 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $102,198 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 181 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $5,004 | Total amount of fees paid to insurance company | USD $6,135 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,004 | Amount paid for insurance broker fees | 6135 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 1 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 260 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $67,065 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,494,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $67,065 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 2 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 4 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $38,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 520644 |
Policy instance | 3 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 230 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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? | Yes |
|
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 257001-071 |
Policy instance | 4 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 13 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,490 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 908857 |
Policy instance | 5 |
Insurance contract or identification number | 908857 | Number of Individuals Covered | 268 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $11,062 | Total amount of fees paid to insurance company | USD $3,893 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $118,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,161 | Amount paid for insurance broker fees | 3236 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 7 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 181 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $3,397 | Total amount of fees paid to insurance company | USD $4,156 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $33,970 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,959 | Amount paid for insurance broker fees | 3627 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 389705 |
Policy instance | 5 |
Insurance contract or identification number | 389705 | Number of Individuals Covered | 148 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $10,546 | Total amount of fees paid to insurance company | USD $5,643 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $131,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,546 | Amount paid for insurance broker fees | 5643 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 2 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 3 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 1 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 274 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $103,761 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,509,943 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $103,761 | Amount paid for insurance broker fees | 0 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 908857 |
Policy instance | 6 |
Insurance contract or identification number | 908857 | Number of Individuals Covered | 109 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,924 | Total amount of fees paid to insurance company | USD $194 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,283 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 7 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 200 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $5,695 | Total amount of fees paid to insurance company | USD $7,582 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,695 | Amount paid for insurance broker fees | 7582 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 200 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $3,843 | Total amount of fees paid to insurance company | USD $5,112 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $38,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,843 | Amount paid for insurance broker fees | 5112 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
|
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 520644 |
Policy instance | 3 |
Insurance contract or identification number | 520644 | Number of Individuals Covered | 260 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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? | Yes |
|
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 257001-071 |
Policy instance | 4 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 14 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $347 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $347 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 2 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 12 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $118,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 1 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 383 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $125,985 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,177,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $125,985 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | STERLING & STERLING LLC |
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UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0000520644 |
Policy instance | 3 |
Insurance contract or identification number | 0000520644 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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? | Yes |
|
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
Policy contract number | 257001071 |
Policy instance | 4 |
Insurance contract or identification number | 257001071 | Number of Individuals Covered | 14 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $351 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,967 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $351 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ERC OF NEW YORK, INC. |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 5 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 194 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $10,982 | Total amount of fees paid to insurance company | USD $1,832 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $157,553 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,973 | Amount paid for insurance broker fees | 1832 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 908857 |
Policy instance | 6 |
Insurance contract or identification number | 908857 | Number of Individuals Covered | 142 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $2,441 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,711 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,671 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | EMERSON REID AND COMPANY, INC. |
|
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | G224478 |
Policy instance | 7 |
Insurance contract or identification number | G224478 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 287 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $7,877 | Total amount of fees paid to insurance company | USD $8,123 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $78,762 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,281 | Amount paid for insurance broker fees | 8123 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 287 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $5,295 | Total amount of fees paid to insurance company | USD $5,462 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $52,945 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,895 | Amount paid for insurance broker fees | 5462 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 10 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $713 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $535 | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 155 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $3,864 | Total amount of fees paid to insurance company | USD $6,060 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $124,253 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,864 | Amount paid for insurance broker fees | 6060 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 5 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 213 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-06-01 | Total amount of commissions paid to insurance broker | USD $454 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,535 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $454 | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 6 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 14 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $4,048 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | PERSONAL CHOICE | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,048 | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $25,916 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | BLUE CROSS & MAJOR MEDICAL | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,916 | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 177 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-06-01 | Total amount of commissions paid to insurance broker | USD $4,077 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,767 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,077 | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 9 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 16 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 10 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 213 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-06-01 | Total amount of commissions paid to insurance broker | USD $4,535 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,348 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,535 | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 246 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $68,872 | Total amount of fees paid to insurance company | USD $535 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,731,582 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,872 | Amount paid for insurance broker fees | 535 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 16 | Insurance policy start date | 2015-11-01 | Insurance policy end date | 2016-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $133,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 129 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $3,636 | Total amount of fees paid to insurance company | USD $4,496 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $109,131 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,636 | Amount paid for insurance broker fees | 4496 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 10 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $713 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $535 | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 246 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $68,872 | Total amount of fees paid to insurance company | USD $535 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,731,582 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,872 | Amount paid for insurance broker fees | 535 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 21 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $147,187 | 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: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 5 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 177 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-06-01 | Total amount of commissions paid to insurance broker | USD $408 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,077 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $408 | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 6 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 14 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $4,048 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | PERSONAL CHOICE | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,048 | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $25,916 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | BLUE CROSS & MAJOR MEDICAL | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,916 | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 177 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-06-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,767 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 177 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-06-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,261 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 10 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 16 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 130 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $3,698 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,232 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,668 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | FORT GENERAL AGENCY, INC. |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 13 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,378 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 10 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $713 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $535 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 239 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $65,274 | Total amount of fees paid to insurance company | USD $1,311 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,627,718 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $65,274 | Amount paid for insurance broker fees | 1311 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 5 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 182 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $599 | Total amount of fees paid to insurance company | USD $331 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,994 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $599 | Amount paid for insurance broker fees | 331 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 6 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 8 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,048 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | PERSONAL CHOICE | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,048 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | BLUE CROSS & MAJOR MEDICAL | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 182 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $4,196 | Total amount of fees paid to insurance company | USD $2,318 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,957 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,196 | Amount paid for insurance broker fees | 2318 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 182 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $2,976 | Total amount of fees paid to insurance company | USD $1,638 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,764 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,976 | Amount paid for insurance broker fees | 1638 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 10 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 16 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 239 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $61,554 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,518,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $61,554 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, AND NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 20 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,621 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 133 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $3,826 | Total amount of fees paid to insurance company | USD $6,613 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,170 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,788 | Amount paid for insurance broker fees | 6613 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | FORT GENERAL AGENCY, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 5 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 188 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $613 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,130 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $613 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 6 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 8 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,912 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | PERSONAL CHOICE | Welfare Benefit Premiums Paid to Carrier | USD $63,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,912 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $523 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | MAJOR MEDICAL & MEDICAL SUPPLIES | Welfare Benefit Premiums Paid to Carrier | USD $25,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $265 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 8 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 188 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,291 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,291 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 188 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,031 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,311 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,031 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 10 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 11 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,311 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 10 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $655 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $3,273 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $491 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 226 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $65,827 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,322,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $65,827 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 10 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 187 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,419 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,578 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,419 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 187 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,949 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,260 | 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 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 8 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $503 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | MAJOR MEDICAL & MEDICAL SUPPLIES | Welfare Benefit Premiums Paid to Carrier | USD $25,804 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $471 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 9 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,704 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | PERSONAL CHOICE | Welfare Benefit Premiums Paid to Carrier | USD $52,063 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,640 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | CDBI, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 187 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $707 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,894 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $707 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, INC. |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 5 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 11 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,601 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 131 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,554 | Total amount of fees paid to insurance company | USD $6,090 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 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 $3,519 | Amount paid for insurance broker fees | 6090 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | FORT GENERAL AGENCY, INC. |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 27 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 9 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $555 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $2,776 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $416 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 7 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $2,392 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | PERSONAL CHOICE | Welfare Benefit Premiums Paid to Carrier | USD $43,705 | 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: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 10 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 168 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,544 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 200 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $63,069 | Total amount of fees paid to insurance company | USD $1,980 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,273,039 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 26 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 127 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $2,529 | Total amount of fees paid to insurance company | USD $3,433 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 5 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 7 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,364 | 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: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 168 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $664 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 9 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $477 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $2,388 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 8 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $376 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | MAJOR MEDICAL & MEDICAL SUPPLIES | Welfare Benefit Premiums Paid to Carrier | USD $25,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 168 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,717 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,577 | 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: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 10 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 161 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,553 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $195 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | MAJOR MEDICAL & MEDICAL SUPPLIES | Welfare Benefit Premiums Paid to Carrier | USD $23,317 | 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: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 161 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $383 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 5 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 7 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,025 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 4 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 6 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,801 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | PERSONAL CHOICE | Welfare Benefit Premiums Paid to Carrier | USD $34,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 3 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 185 | Insurance policy start date | 2009-06-01 | Insurance policy end date | 2010-05-31 | Total amount of commissions paid to insurance broker | USD $55,786 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,135,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 2 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 123 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,445 | Total amount of fees paid to insurance company | USD $2,397 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 9 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 9 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $439 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $2,110 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 1 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 161 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,572 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,184 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 8 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 22 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | WF03901 |
Policy instance | 2 |
Insurance contract or identification number | WF03901 | Number of Individuals Covered | 180 | Insurance policy start date | 2008-06-01 | Insurance policy end date | 2009-05-31 | Total amount of commissions paid to insurance broker | USD $43,952 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $886,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,952 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | BONUS, ADMINISTRATIVE SERVICES, NON-MONETARY PAYMENT | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, LLC |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | G224478 |
Policy instance | 1 |
Insurance contract or identification number | G224478 | Number of Individuals Covered | 9 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $384 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D & SHORT-TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $1,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $307 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Insurance broker name | CRAWFORD ADVISORS LLC |
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MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
Policy contract number | 201545 |
Policy instance | 3 |
Insurance contract or identification number | 201545 | Number of Individuals Covered | 14 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00389705 |
Policy instance | 4 |
Insurance contract or identification number | 00389705 | Number of Individuals Covered | 115 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $3,332 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 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 $3,332 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, LLC |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 257001-071 |
Policy instance | 5 |
Insurance contract or identification number | 257001-071 | Number of Individuals Covered | 5 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 ) |
Policy contract number | 0000520644 |
Policy instance | 7 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 5 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $1,941 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | PERSONAL CHOICE | Welfare Benefit Premiums Paid to Carrier | USD $34,716 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,941 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | GREATER PHILA. CHAMBER OF COMMERCE |
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INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 0000520644 |
Policy instance | 8 |
Insurance contract or identification number | 0000520644 | Number of Individuals Covered | 2 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | MAJOR MEDICAL & MEDICAL SUPPLIES | Welfare Benefit Premiums Paid to Carrier | USD $22,479 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GLCL0ABY7 |
Policy instance | 9 |
Insurance contract or identification number | GLCL0ABY7 | Number of Individuals Covered | 150 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $1,939 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,386 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,939 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | GMTD0ABY7 |
Policy instance | 10 |
Insurance contract or identification number | GMTD0ABY7 | Number of Individuals Covered | 150 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $1,895 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,895 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | MP0ABY7 |
Policy instance | 6 |
Insurance contract or identification number | MP0ABY7 | Number of Individuals Covered | 150 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $258 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $2,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $258 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | N/A | Insurance broker organization code? | 3 | Insurance broker name | STERLING AND STERLING, LLC |
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