401k Plan data: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN plan

SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN
Plan identification number	501

SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SAFE FLIGHT INSTRUMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name: SAFE FLIGHT INSTRUMENT, LLC

Employer identification number (EIN): 131729066

NAIC Classification: 334500

Additional information about SAFE FLIGHT INSTRUMENT, LLC

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1975-07-22

Company Identification Number: 375585

Legal Registered Office Address: 20 NEW KING ST.
WESTCHESTER
WHITE PLAINS
United States of America (USA)
10604

More information about SAFE FLIGHT INSTRUMENT, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 PAMELA JOHNSON 2023-07-07
501 2021-01-01 ANN MARIE HOFFENBERG 2022-09-21
501 2020-01-01 ANN MARIE HOFFENBERG 2021-08-24
501 2019-01-01
501 2018-01-01 PAUL VIER
501 2017-01-01 PAUL VIER
501 2016-01-01 PAUL VIER PAUL VIER 2017-07-18
501 2015-01-01 PAUL VIER
501 2014-01-01 PAUL VIER
501 2013-01-01 PAUL VIER
501 2012-01-01 PAUL VIER
501 2011-01-01 PAUL VIER
501 2010-01-01 PAUL VIER
501 2009-01-01 PAUL VIER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	PAMELA JOHNSON	2023-07-07
501	2021-01-01	ANN MARIE HOFFENBERG	2022-09-21
501	2020-01-01	ANN MARIE HOFFENBERG	2021-08-24
501	2019-01-01
501	2018-01-01	PAUL VIER
501	2017-01-01	PAUL VIER
501	2016-01-01	PAUL VIER		PAUL VIER	2017-07-18
501	2015-01-01	PAUL VIER
501	2014-01-01	PAUL VIER
501	2013-01-01	PAUL VIER
501	2012-01-01	PAUL VIER
501	2011-01-01	PAUL VIER
501	2010-01-01	PAUL VIER
501	2009-01-01	PAUL VIER

Plan Statistics for SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN

Measure Date Value
2022: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 107
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 102
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 102
Number of employers contributing to the scheme 2022-01-01 0
2021: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 107
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 107
Number of employers contributing to the scheme 2021-01-01 0
2020: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 109
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 109
Number of employers contributing to the scheme 2020-01-01 0
2019: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 199
Total of all active and inactive participants 2019-01-01 199
2018: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 210
Total of all active and inactive participants 2018-01-01 210
2017: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 109
Total of all active and inactive participants 2017-01-01 109
Total participants 2017-01-01 109
2016: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 112
Total of all active and inactive participants 2016-01-01 112
Total participants 2016-01-01 112
2015: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 123
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 123
Total participants 2015-01-01 123
2014: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 131
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 124
Number of retired or separated participants receiving benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 127
Total participants 2014-01-01 127
2013: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 131
Total of all active and inactive participants 2013-01-01 131
Total participants 2013-01-01 131
2012: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 133
Total of all active and inactive participants 2012-01-01 133
Total participants 2012-01-01 133
2011: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 137
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 137
Total participants 2011-01-01 137
2010: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 138
Number of retired or separated participants receiving benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 139
Total participants 2010-01-01 139
2009: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 142
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 143
Total participants 2009-01-01 143

Measure	Date	Value
2022: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	107
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	102
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	102
Number of employers contributing to the scheme	2022-01-01	0
2021: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	107
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	107
Number of employers contributing to the scheme	2021-01-01	0
2020: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	109
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	109
Number of employers contributing to the scheme	2020-01-01	0
2019: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	199
Total of all active and inactive participants	2019-01-01	199
2018: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	210
Total of all active and inactive participants	2018-01-01	210
2017: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	109
Total of all active and inactive participants	2017-01-01	109
Total participants	2017-01-01	109
2016: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	112
Total of all active and inactive participants	2016-01-01	112
Total participants	2016-01-01	112
2015: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	123
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	123
Total participants	2015-01-01	123
2014: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	131
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	124
Number of retired or separated participants receiving benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	127
Total participants	2014-01-01	127
2013: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	131
Total of all active and inactive participants	2013-01-01	131
Total participants	2013-01-01	131
2012: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	133
Total of all active and inactive participants	2012-01-01	133
Total participants	2012-01-01	133
2011: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	137
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	137
Total participants	2011-01-01	137
2010: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	138
Number of retired or separated participants receiving benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	139
Total participants	2010-01-01	139
2009: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	142
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	143
Total participants	2009-01-01	143

Form 5500 Responses for SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN

2022: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
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: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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
2019: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: SAFE FLIGHT INSTRUMENT, LLC EMPLOYEE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

804497G

Policy instance

Insurance contract or identification number	804497G
Number of Individuals Covered	102
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $211
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $49,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $211
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

10202511001

Policy instance

Insurance contract or identification number	10202511001
Number of Individuals Covered	185
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,117
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,117
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05956044

Policy instance

Insurance contract or identification number	TS05956044
Number of Individuals Covered	239
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $8,160
Total amount of fees paid to insurance company	USD $1,900
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $95,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,804
Amount paid for insurance broker fees	694
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05956044

Policy instance

Insurance contract or identification number	TS05956044
Number of Individuals Covered	257
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $7,105
Total amount of fees paid to insurance company	USD $1,859
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $100,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,026
Amount paid for insurance broker fees	735
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

804497G

Policy instance

Insurance contract or identification number	804497G
Number of Individuals Covered	107
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $630
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $50,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $415
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

10202511001

Policy instance

Insurance contract or identification number	10202511001
Number of Individuals Covered	190
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,861
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,074
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION

HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )

Policy contract number

1130308000

Policy instance

Insurance contract or identification number	1130308000
Number of Individuals Covered	156
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $79,587
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,989,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $79,587
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

10202511001

Policy instance

Insurance contract or identification number	10202511001
Number of Individuals Covered	193
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,197
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,197
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )

Policy contract number

1130308

Policy instance

Insurance contract or identification number	1130308
Number of Individuals Covered	170
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $78,725
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,968,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78,725
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

804497G

Policy instance

Insurance contract or identification number	804497G
Number of Individuals Covered	109
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $225
Total amount of fees paid to insurance company	USD $2,477
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $49,544
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	2477
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	116
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
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
Welfare Benefit Premiums Paid to Carrier	USD $18,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05956044

Policy instance

Insurance contract or identification number	TS05956044
Number of Individuals Covered	267
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,667
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $91,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,547
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )

Policy contract number

300247

Policy instance

Insurance contract or identification number	300247
Number of Individuals Covered	171
Total amount of commissions paid to insurance broker	USD $73,207
Total amount of fees paid to insurance company	USD $14,010
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,984,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $60,762
Amount paid for insurance broker fees	14010

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

10202511001

Policy instance

Insurance contract or identification number	10202511001
Number of Individuals Covered	199
Total amount of commissions paid to insurance broker	USD $1,077
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,772
Commission paid to Insurance Broker	USD $1,077

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05956044

Policy instance

Insurance contract or identification number	TS05956044
Number of Individuals Covered	100
Total amount of commissions paid to insurance broker	USD $5,107
Total amount of fees paid to insurance company	USD $14
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $94,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,198
Amount paid for insurance broker fees	14

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0847973

Policy instance

Insurance contract or identification number	0847973
Number of Individuals Covered	112
Total amount of commissions paid to insurance broker	USD $6,664
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $58,320
Commission paid to Insurance Broker	USD $6,664

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	113
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,196

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0847973

Policy instance

Insurance contract or identification number	0847973
Number of Individuals Covered	210
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $76,005
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $69,535

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	210
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,063

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	109
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0847973

Policy instance

Insurance contract or identification number	0847973
Number of Individuals Covered	109
Total amount of commissions paid to insurance broker	USD $104,549
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,189,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $90,725
Insurance broker name	ERIC GULKO

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	123
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	123
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,531
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	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	123
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Total amount of commissions paid to insurance broker	USD $280
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $1,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $280
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	123
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Total amount of commissions paid to insurance broker	USD $2,289
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,289
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	127
Insurance policy start date	2013-12-01
Insurance policy end date	2014-11-30
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	127
Insurance policy start date	2013-12-01
Insurance policy end date	2014-11-30
Total amount of commissions paid to insurance broker	USD $287
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $287
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	127
Insurance policy start date	2013-12-01
Insurance policy end date	2014-11-30
Total amount of commissions paid to insurance broker	USD $2,319
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,375
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,319
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	127
Insurance policy start date	2013-12-01
Insurance policy end date	2014-11-30
Total amount of commissions paid to insurance broker	USD $3,411
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,411
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	131
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Total amount of commissions paid to insurance broker	USD $3,569
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,569
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	131
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	131
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Total amount of commissions paid to insurance broker	USD $320
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $320
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	131
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Total amount of commissions paid to insurance broker	USD $2,499
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,499
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	133
Insurance policy start date	2011-12-01
Insurance policy end date	2012-11-30
Total amount of commissions paid to insurance broker	USD $2,409
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $28,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,409
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

NEW YORK STATE INSURANCE FUND (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6113642

Policy instance

Insurance contract or identification number	6113642
Number of Individuals Covered	133
Insurance policy start date	2011-12-01
Insurance policy end date	2012-11-30
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	136
Insurance policy start date	2011-12-01
Insurance policy end date	2012-11-30
Total amount of commissions paid to insurance broker	USD $3,409
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,409
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	133
Insurance policy start date	2011-12-01
Insurance policy end date	2012-11-30
Total amount of commissions paid to insurance broker	USD $2,039
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,039
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	137
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $305
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	137
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $3,475
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	137
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $2,401
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

NYD600086

Policy instance

Insurance contract or identification number	NYD600086
Number of Individuals Covered	136
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $972
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD601477

Policy instance

Insurance contract or identification number	SGD601477
Number of Individuals Covered	136
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $1,315
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SYK600039

Policy instance

Insurance contract or identification number	SYK600039
Number of Individuals Covered	138
Insurance policy start date	2009-12-01
Insurance policy end date	2010-11-30
Total amount of commissions paid to insurance broker	USD $309
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $309
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGE600056

Policy instance

Insurance contract or identification number	SGE600056
Number of Individuals Covered	138
Insurance policy start date	2009-12-01
Insurance policy end date	2010-11-30
Total amount of commissions paid to insurance broker	USD $3,128
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,128
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD601477

Policy instance

Insurance contract or identification number	SGD601477
Number of Individuals Covered	138
Insurance policy start date	2009-12-01
Insurance policy end date	2010-11-30
Total amount of commissions paid to insurance broker	USD $1,226
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )

Policy contract number

SGN600254

Policy instance

Insurance contract or identification number	SGN600254
Number of Individuals Covered	138
Insurance policy start date	2009-12-01
Insurance policy end date	2010-11-30
Total amount of commissions paid to insurance broker	USD $2,386
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,386
Insurance broker organization code?	3
Insurance broker name	SUMMIT FINANCIAL INSURANCE AGENCY

Potentially related plans

SAFE FLIGHT AVIATION INC - 401K PLAN [EIN = 843175154]

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Company Name:	SAFE FLIGHT INSTRUMENT, LLC
Employer identification number (EIN):	131729066
NAIC Classification:	334500

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1975-07-22
Company Identification Number:	375585
Legal Registered Office Address:	20 NEW KING ST. WESTCHESTER WHITE PLAINS United States of America (USA) 10604