AXELON SERVICES CORPORATION has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022: AXELON SERVICES CORPORATION 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 124 |
| Total of all active and inactive participants | 2022-01-01 | 124 |
| 2021: AXELON SERVICES CORPORATION 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 137 |
| Total of all active and inactive participants | 2021-01-01 | 137 |
| 2020: AXELON SERVICES CORPORATION 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 144 |
| Total of all active and inactive participants | 2020-01-01 | 144 |
| 2018: AXELON SERVICES CORPORATION 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 147 |
| Total of all active and inactive participants | 2018-01-01 | 147 |
| 2017: AXELON SERVICES CORPORATION 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 88 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 117 |
| Total of all active and inactive participants | 2017-01-01 | 117 |
| 2016: AXELON SERVICES CORPORATION 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 192 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 190 |
| Total of all active and inactive participants | 2016-01-01 | 190 |
| 2015: AXELON SERVICES CORPORATION 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 238 |
| Total of all active and inactive participants | 2015-01-01 | 238 |
| 2022: AXELON SERVICES CORPORATION 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: AXELON SERVICES CORPORATION 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: AXELON SERVICES CORPORATION 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: AXELON SERVICES CORPORATION 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: AXELON SERVICES CORPORATION 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: AXELON SERVICES CORPORATION 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: AXELON SERVICES CORPORATION 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00009562 |
| Policy instance | 4 |
| Insurance contract or identification number | 00009562 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,831 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $134,035 | | Commission paid to Insurance Broker | USD $4,373 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3214172 |
| Policy instance | 3 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $228 | | Total amount of fees paid to insurance company | USD $285 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,701 | | Commission paid to Insurance Broker | USD $228 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 285 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00568019 |
| Policy instance | 2 |
| Insurance contract or identification number | 00568019 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $34,489 | | Total amount of fees paid to insurance company | USD $64,705 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $215,626 | | Commission paid to Insurance Broker | USD $34,489 | | Amount paid for insurance broker fees | 64705 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3214172 |
| Policy instance | 1 |
| Insurance contract or identification number | 3214172 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,594 | | Total amount of fees paid to insurance company | USD $1,993 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,168 | | Commission paid to Insurance Broker | USD $1,594 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1993 | | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN200014 |
| Policy instance | 6 |
| Insurance contract or identification number | SGN200014 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $131 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,280 | | Commission paid to Insurance Broker | USD $131 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 ) |
| Policy contract number | 3214172 |
| Policy instance | 5 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $41 | | Total amount of fees paid to insurance company | USD $51 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,021 | | Commission paid to Insurance Broker | USD $41 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 51 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3214172 |
| Policy instance | 1 |
| Insurance contract or identification number | 3214172 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,675 | | Total amount of fees paid to insurance company | USD $3,093 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,225 | | Amount paid for insurance broker fees | 3093 | | Additional information about fees paid to insurance broker | GENERAL PAYMENT | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,675 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00568019 |
| Policy instance | 2 |
| Insurance contract or identification number | 00568019 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $42,087 | | Total amount of fees paid to insurance company | USD $73,986 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $228,842 | | Commission paid to Insurance Broker | USD $42,087 | | Amount paid for insurance broker fees | 73986 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3214172 |
| Policy instance | 3 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $239 | | Total amount of fees paid to insurance company | USD $298 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,970 | | Commission paid to Insurance Broker | USD $239 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 298 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00009562 |
| Policy instance | 4 |
| Insurance contract or identification number | 00009562 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,219 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $145,949 | | Commission paid to Insurance Broker | USD $3,914 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 ) |
| Policy contract number | 3214172 |
| Policy instance | 5 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $40 | | Total amount of fees paid to insurance company | USD $50 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,009 | | Commission paid to Insurance Broker | USD $40 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 50 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN200014 |
| Policy instance | 6 |
| Insurance contract or identification number | SGN200014 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $175 | | Welfare Benefit Premiums Paid to Carrier | USD $4,370 | | Commission paid to Insurance Broker | USD $175 | | Additional information about fees paid to insurance broker | STANDARD COMMISSIONS | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $45 | | Total amount of fees paid to insurance company | USD $56 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,124 | | Commission paid to Insurance Broker | USD $45 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 56 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 00009562 |
| Policy instance | 4 |
| Insurance contract or identification number | 00009562 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $7,137 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $176,804 | | Commission paid to Insurance Broker | USD $5,768 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $243 | | Total amount of fees paid to insurance company | USD $304 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,087 | | Commission paid to Insurance Broker | USD $243 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 304 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00568019 |
| Policy instance | 2 |
| Insurance contract or identification number | 00568019 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $138,494 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $215,860 | | Commission paid to Insurance Broker | USD $138,494 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3214172 |
| Policy instance | 1 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,665 | | Total amount of fees paid to insurance company | USD $2,271 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,005 | | Commission paid to Insurance Broker | USD $1,665 | | Amount paid for insurance broker fees | 25 | | Additional information about fees paid to insurance broker | GENERAL PAYMENT | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF NEW JERSEY, INC. (National Association of Insurance Commissioners NAIC id number: 11167 ) |
| Policy contract number | 3214172 |
| Policy instance | 1 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $383 | | Total amount of fees paid to insurance company | USD $478 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,563 | | Commission paid to Insurance Broker | USD $383 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 478 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3214172 |
| Policy instance | 2 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,731 | | Total amount of fees paid to insurance company | USD $2,164 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,076 | | Amount paid for insurance broker fees | 2164 | | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,731 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN200014 |
| Policy instance | 3 |
| Insurance contract or identification number | SGN200014 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $227 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC DEATH & DISMEMB | | Welfare Benefit Premiums Paid to Carrier | USD $5,667 | | Commission paid to Insurance Broker | USD $227 | | Insurance broker organization code? | 3 |
|
| CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47041 ) |
| Policy contract number | 3214172 |
| Policy instance | 4 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $28 | | Total amount of fees paid to insurance company | USD $35 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $697 | | Commission paid to Insurance Broker | USD $28 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 35 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00568019 |
| Policy instance | 5 |
| Insurance contract or identification number | 00568019 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $34,802 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $193,058 | | Commission paid to Insurance Broker | USD $34,802 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 95620001 |
| Policy instance | 6 |
| Insurance contract or identification number | 95620001 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $6,644 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $167,367 | | Commission paid to Insurance Broker | USD $6,644 | | Insurance broker organization code? | 3 |
|
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) |
| Policy contract number | 95620001 |
| Policy instance | 4 |
| Insurance contract or identification number | 95620001 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,480 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $162,663 | | Commission paid to Insurance Broker | USD $6,480 | | Insurance broker organization code? | 3 | | Insurance broker name | LIFETIME BENEFIT SOLUTIONS, INC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00568019 |
| Policy instance | 3 |
| Insurance contract or identification number | 00568019 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $29,663 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156,868 | | Commission paid to Insurance Broker | USD $29,663 | | Insurance broker organization code? | 3 | | Insurance broker name | CENTERSTONE INS & FIN SERV |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN200014 |
| Policy instance | 2 |
| Insurance contract or identification number | SGN200014 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $202 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACC DEATH & DISMEMB | | Welfare Benefit Premiums Paid to Carrier | USD $5,055 | | Commission paid to Insurance Broker | USD $202 | | Insurance broker organization code? | 3 | | Insurance broker name | EDWARD P LEVINS |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3214172 |
| Policy instance | 1 |
| Insurance contract or identification number | 3214172 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,124 | | Total amount of fees paid to insurance company | USD $2,655 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,501 | | Amount paid for insurance broker fees | 2655 | | Additional information about fees paid to insurance broker | SERVICE/GENERAL AGENT PAYMENTS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $2,124 | | Insurance broker name | DKG INSURANCE & FINANCIAL SERV INC |
|
| THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) |
| Policy contract number | E4398517 |
| Policy instance | 1 |
| Insurance contract or identification number | E4398517 | | 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 $3,607 | | Total amount of fees paid to insurance company | USD $3,350 | | Other welfare benefits provided | HOSPITAL INDEMNITY PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $13,606 | | Commission paid to Insurance Broker | USD $1,701 | | Amount paid for insurance broker fees | 3350 | | Insurance broker organization code? | 3 | | Insurance broker name | BRAD BIEL |
|
