RUBENSTEIN ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.
Additional information about RUBENSTEIN ASSOCIATES, INC.
Submission information for form 5500 for 401k plan RUBENSTEIN ASSOCIATES, INC.
401k plan membership statisitcs for RUBENSTEIN ASSOCIATES, INC.
| Measure | Date | Value |
|---|
| 2022: RUBENSTEIN ASSOCIATES, INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 139 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 4 |
| Total of all active and inactive participants | 2022-01-01 | 143 |
| Total participants | 2022-01-01 | 143 |
| 2021: RUBENSTEIN ASSOCIATES, INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 144 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 3 |
| Total of all active and inactive participants | 2021-01-01 | 147 |
| Total participants | 2021-01-01 | 147 |
| 2020: RUBENSTEIN ASSOCIATES, INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 132 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 9 |
| Total of all active and inactive participants | 2020-01-01 | 141 |
| Total participants | 2020-01-01 | 141 |
| 2019: RUBENSTEIN ASSOCIATES, INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 154 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
| Total of all active and inactive participants | 2019-01-01 | 155 |
| Total participants | 2019-01-01 | 155 |
| 2018: RUBENSTEIN ASSOCIATES, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 153 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
| Total of all active and inactive participants | 2018-01-01 | 156 |
| Total participants | 2018-01-01 | 156 |
| 2017: RUBENSTEIN ASSOCIATES, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 144 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 9 |
| Total of all active and inactive participants | 2017-01-01 | 153 |
| Total participants | 2017-01-01 | 153 |
| 2016: RUBENSTEIN ASSOCIATES, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 167 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 4 |
| Total of all active and inactive participants | 2016-01-01 | 171 |
| Total participants | 2016-01-01 | 171 |
| 2015: RUBENSTEIN ASSOCIATES, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 163 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 4 |
| Total of all active and inactive participants | 2015-01-01 | 167 |
| Total participants | 2015-01-01 | 0 |
| 2014: RUBENSTEIN ASSOCIATES, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 169 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 2 |
| Total of all active and inactive participants | 2014-01-01 | 171 |
| Total participants | 2014-01-01 | 0 |
| 2013: RUBENSTEIN ASSOCIATES, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 164 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 4 |
| Total of all active and inactive participants | 2013-01-01 | 168 |
| Total participants | 2013-01-01 | 0 |
| 2012: RUBENSTEIN ASSOCIATES, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 216 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 6 |
| Total of all active and inactive participants | 2012-01-01 | 222 |
| Total participants | 2012-01-01 | 0 |
| 2011: RUBENSTEIN ASSOCIATES, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 206 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 6 |
| Total of all active and inactive participants | 2011-01-01 | 212 |
| Total participants | 2011-01-01 | 212 |
| 2010: RUBENSTEIN ASSOCIATES, INC. 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 193 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 215 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 7 |
| Total of all active and inactive participants | 2010-01-01 | 222 |
| Total participants | 2010-01-01 | 222 |
| 2009: RUBENSTEIN ASSOCIATES, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 183 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 10 |
| Total of all active and inactive participants | 2009-01-01 | 193 |
| Total participants | 2009-01-01 | 0 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 335102 |
| Policy instance | 4 |
| Insurance contract or identification number | 335102 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $52,290 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,423,255 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,290 | | Additional information about fees paid to insurance broker | SALES & SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 70536 |
| Policy instance | 3 |
| Insurance contract or identification number | 70536 | | Number of Individuals Covered | 139 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $9,839 | | Total amount of fees paid to insurance company | USD $26 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH, PFL | | Welfare Benefit Premiums Paid to Carrier | USD $128,722 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,501 | | Additional information about fees paid to insurance broker | SALES & SERVICE COMPENSATION | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 26 |
|
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
| Policy contract number | 10149561001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10149561001 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $255 | | Total amount of fees paid to insurance company | USD $318 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 318 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $255 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 923002 |
| Policy instance | 1 |
| Insurance contract or identification number | 923002 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,158 | | Total amount of fees paid to insurance company | USD $2,666 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,891 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2666 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL BONUS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $1,158 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0923002 |
| Policy instance | 1 |
| Insurance contract or identification number | 0923002 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,743 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,743 | | Additional information about fees paid to insurance broker | DENTAL | | 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 | 10149561001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10149561001 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $669 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $372 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 70536 |
| Policy instance | 3 |
| Insurance contract or identification number | 70536 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $7,453 | | Total amount of fees paid to insurance company | USD $24 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH, PFL | | Welfare Benefit Premiums Paid to Carrier | USD $124,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,453 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 24 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 335102 |
| Policy instance | 4 |
| Insurance contract or identification number | 335102 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $70,486 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,611,405 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70,486 | | Additional information about fees paid to insurance broker | MEDICAL INSURANCE | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0108800 |
| Policy instance | 1 |
| Insurance contract or identification number | 0108800 | | Number of Individuals Covered | 93 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $96,392 | | Total amount of fees paid to insurance company | USD $9,284 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,675,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,055 | | Amount paid for insurance broker fees | 9284 | | Additional information about fees paid to insurance broker | MEDICAL INSURANCE | | 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 | 10149561001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10149561001 | | Number of Individuals Covered | 74 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $576 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,376 | | 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 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYD600636 |
| Policy instance | 3 |
| Insurance contract or identification number | NYD600636 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,165 | | Total amount of fees paid to insurance company | USD $2,106 | | Other welfare benefits provided | STATUTORY DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $33,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,165 | | Amount paid for insurance broker fees | 451 | | Additional information about fees paid to insurance broker | STATUTORY DISABILITY | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGE600448 |
| Policy instance | 4 |
| Insurance contract or identification number | SGE600448 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,648 | | Total amount of fees paid to insurance company | USD $2,545 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,648 | | Amount paid for insurance broker fees | 739 | | Additional information about fees paid to insurance broker | LONG TERM DISABILITY | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN600738 |
| Policy instance | 5 |
| Insurance contract or identification number | SGN600738 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,645 | | Total amount of fees paid to insurance company | USD $2,446 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,907 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,645 | | Amount paid for insurance broker fees | 801 | | Additional information about fees paid to insurance broker | BASIC LIFE/SUPP LIFE/DEPENDENT LIFE | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SYK600380 |
| Policy instance | 6 |
| Insurance contract or identification number | SYK600380 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $277 | | Total amount of fees paid to insurance company | USD $180 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $2,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $277 | | Amount paid for insurance broker fees | 55 | | Additional information about fees paid to insurance broker | ACCIDENTAL DEATH | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 286108-10/11 |
| Policy instance | 7 |
| Insurance contract or identification number | 286108-10/11 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $4,468 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4468 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0108800 |
| Policy instance | 1 |
| Insurance contract or identification number | 0108800 | | Number of Individuals Covered | 227 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $62,179 | | Total amount of fees paid to insurance company | USD $27,329 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,691,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,179 | | Amount paid for insurance broker fees | 126 | | Additional information about fees paid to insurance broker | MEDICAL INSURANCE | | 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 | 10149561001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10149561001 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $632 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,015 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $351 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYD600636 |
| Policy instance | 3 |
| Insurance contract or identification number | NYD600636 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,570 | | Total amount of fees paid to insurance company | USD $1,180 | | Other welfare benefits provided | STATUTORY DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $23,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,570 | | Additional information about fees paid to insurance broker | STATUTORY DISABILITY | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1180 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGE600448 |
| Policy instance | 4 |
| Insurance contract or identification number | SGE600448 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,850 | | Total amount of fees paid to insurance company | USD $1,850 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,005 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,850 | | Additional information about fees paid to insurance broker | LONG TERM DISABILITY | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1850 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN600738 |
| Policy instance | 5 |
| Insurance contract or identification number | SGN600738 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,951 | | Total amount of fees paid to insurance company | USD $1,951 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,951 | | Additional information about fees paid to insurance broker | BASIC LIFE/SUPP LIFE/DEPENDENT LIFE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1951 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SYK600380 |
| Policy instance | 6 |
| Insurance contract or identification number | SYK600380 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $330 | | Total amount of fees paid to insurance company | USD $137 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $2,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $330 | | Additional information about fees paid to insurance broker | ACCIDENTAL DEATH | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 137 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 286108-10/11 |
| Policy instance | 7 |
| Insurance contract or identification number | 286108-10/11 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $4,112 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $77,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4112 | | Additional information about fees paid to insurance broker | DENTAL | | 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 | 617993 |
| Policy instance | 1 |
| Insurance contract or identification number | 617993 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $56,528 | | Total amount of fees paid to insurance company | USD $37,714 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,753,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,528 | | Additional information about fees paid to insurance broker | MEDICAL INSURANCE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 31698 |
|
| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
| Policy contract number | 10149561001 |
| Policy instance | 2 |
| Insurance contract or identification number | 10149561001 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $582 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $463 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYD600636 |
| Policy instance | 3 |
| Insurance contract or identification number | NYD600636 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,421 | | Total amount of fees paid to insurance company | USD $911 | | Other welfare benefits provided | STATUTORY DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $18,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,421 | | Additional information about fees paid to insurance broker | STATUTORY DISABILITY | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 911 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGE600448 |
| Policy instance | 4 |
| Insurance contract or identification number | SGE600448 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,706 | | Total amount of fees paid to insurance company | USD $1,706 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,706 | | Additional information about fees paid to insurance broker | LONG TERM DISABILITY | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1706 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SGN600738 |
| Policy instance | 5 |
| Insurance contract or identification number | SGN600738 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,536 | | Total amount of fees paid to insurance company | USD $1,536 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,536 | | Additional information about fees paid to insurance broker | BASIC LIFE/SUPP LIFE/DEPENDENT LIFE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1536 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 286108-10-00009 |
| Policy instance | 7 |
| Insurance contract or identification number | 286108-10-00009 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $3,906 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,389 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3906 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | SYK600380 |
| Policy instance | 6 |
| Insurance contract or identification number | SYK600380 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $307 | | Total amount of fees paid to insurance company | USD $128 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $2,555 | | 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 | | Additional information about fees paid to insurance broker | ACCIDENTAL DEATH | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 128 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 286108-10-00010 |
| Policy instance | 8 |
| Insurance contract or identification number | 286108-10-00010 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $15 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 15 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 286108-11-0009 |
| Policy instance | 9 |
| Insurance contract or identification number | 286108-11-0009 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $743 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 743 | | Additional information about fees paid to insurance broker | DENTAL | | 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 | 617993 |
| Policy instance | 5 |
| Insurance contract or identification number | 617993 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $54,138 | | Total amount of fees paid to insurance company | USD $30,358 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,689,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,138 | | Additional information about fees paid to insurance broker | HEALTH INSURANCE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 30358 | | Insurance broker name | HEALTHY BUSINESS GROUP LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 723897-D |
| Policy instance | 4 |
| Insurance contract or identification number | 723897-D | | Number of Individuals Covered | 181 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,203 | | Total amount of fees paid to insurance company | USD $119 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,136 | | Additional information about fees paid to insurance broker | TEMPORARY DISABILITY | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 119 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00610147 |
| Policy instance | 3 |
| Insurance contract or identification number | 00610147 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $5,352 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,678 | | Additional information about fees paid to insurance broker | DENTAL & INDEMNITY | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL NORTHEAST |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 873942G |
| Policy instance | 2 |
| Insurance contract or identification number | 873942G | | Number of Individuals Covered | 144 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $8,057 | | Total amount of fees paid to insurance company | USD $5,471 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEATH BENEFITS | | Welfare Benefit Premiums Paid to Carrier | USD $87,906 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,053 | | Amount paid for insurance broker fees | 4053 | | Additional information about fees paid to insurance broker | LIFE, LONG TERM DISABILITY, DEATH BENEFITS | | Insurance broker organization code? | 3 | | Insurance broker name | FNA INSURANCE SERVICES INC |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 1 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $312 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $312 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00371-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 00371-00 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,575 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,575 | | Additional information about fees paid to insurance broker | TEMPORARY DISABILITY | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $300 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $300 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 873942G |
| Policy instance | 3 |
| Insurance contract or identification number | 873942G | | Number of Individuals Covered | 168 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,059 | | Total amount of fees paid to insurance company | USD $144 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEATH BENEFITS | | Welfare Benefit Premiums Paid to Carrier | USD $73,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,059 | | Additional information about fees paid to insurance broker | LIFE, LONG TERM DISABILITY, DEATH BENEFITS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 144 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00610147 |
| Policy instance | 4 |
| Insurance contract or identification number | 00610147 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $56,509 | | Total amount of fees paid to insurance company | USD $1,278 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $593,929 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,875 | | Amount paid for insurance broker fees | 1278 | | Additional information about fees paid to insurance broker | HEALTH INSURANCE, DENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 873942G |
| Policy instance | 3 |
| Insurance contract or identification number | 873942G | | Number of Individuals Covered | 162 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $9,693 | | Total amount of fees paid to insurance company | USD $1,820 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | DEATH BENEFITS | | Welfare Benefit Premiums Paid to Carrier | USD $83,736 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,693 | | Additional information about fees paid to insurance broker | LIFE, LONG TERM DISABILITY, DEATH BENEFITS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1820 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1921 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,165 | | Total amount of fees paid to insurance company | USD $4,640 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $4,165 | | Amount paid for insurance broker fees | 4640 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00371-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 00371-00 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,573 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,820 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,573 | | Additional information about fees paid to insurance broker | TEMPORARY DISABILITY | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00610147 |
| Policy instance | 4 |
| Insurance contract or identification number | 00610147 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $61,282 | | Total amount of fees paid to insurance company | USD $14,390 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $556,068 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,653 | | Amount paid for insurance broker fees | 14390 | | Additional information about fees paid to insurance broker | HEALTH INSURANCE, DENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00010097304 |
| Policy instance | 1 |
| Insurance contract or identification number | 00010097304 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $3,748 | | Total amount of fees paid to insurance company | USD $734 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,748 | | Additional information about fees paid to insurance broker | LTD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 734 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00400259 |
| Policy instance | 3 |
| Insurance contract or identification number | 00400259 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,329 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,329 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGY LLC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00371-00 |
| Policy instance | 4 |
| Insurance contract or identification number | 00371-00 | | Number of Individuals Covered | 179 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,586 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,906 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,586 | | Additional information about fees paid to insurance broker | TEMPORARY DISABILITY | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 ) |
| Policy contract number | GO458 |
| Policy instance | 5 |
| Insurance contract or identification number | GO458 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $49,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | G1922/G1921 |
| Policy instance | 2 |
| Insurance contract or identification number | G1922/G1921 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $54,001 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,632,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $54,001 | | Additional information about fees paid to insurance broker | HMO, PPO, VISION, HEALTH, PRESCRIPTION | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | G1922/G1921 |
| Policy instance | 4 |
| Insurance contract or identification number | G1922/G1921 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $72,905 | | Total amount of fees paid to insurance company | USD $2,380 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,963,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $72,905 | | Amount paid for insurance broker fees | 2380 | | Additional information about fees paid to insurance broker | HMO, PPO, VISION, HEALTH, PRESCRIPTION | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00010097304 |
| Policy instance | 5 |
| Insurance contract or identification number | 00010097304 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,666 | | Total amount of fees paid to insurance company | USD $1,088 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,715 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,666 | | Amount paid for insurance broker fees | 1088 | | Additional information about fees paid to insurance broker | LTD | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00400259 |
| Policy instance | 3 |
| Insurance contract or identification number | 00400259 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $5,671 | | Total amount of fees paid to insurance company | USD $3,733 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,671 | | Amount paid for insurance broker fees | 3733 | | Additional information about fees paid to insurance broker | DENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| NATIONAL BENEFIT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61409 ) |
| Policy contract number | 0990358 A,-,C |
| Policy instance | 2 |
| Insurance contract or identification number | 0990358 A,-,C | | Number of Individuals Covered | 209 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,369 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,369 | | Additional information about fees paid to insurance broker | TEMPORARY DISABILITY | | Insurance broker organization code? | 3 | | Total amount of fees paid to insurance company | USD $25,647 | | Health Insurance Welfare Benefit | Yes | | Amount paid for insurance broker fees | 25647 | | Insurance broker name | MARSH & MCLENNAN AGY LLC |
|
| ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 ) |
| Policy contract number | GO458 |
| Policy instance | 1 |
| Insurance contract or identification number | GO458 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $51,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 000010097303 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010097303 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,987 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DIMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $49,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00010097304 |
| Policy instance | 4 |
| Insurance contract or identification number | 00010097304 | | Number of Individuals Covered | 201 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $4,611 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,397 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | G1922/G1921 |
| Policy instance | 3 |
| Insurance contract or identification number | G1922/G1921 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $100,566 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,771,661 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00400259 |
| Policy instance | 2 |
| Insurance contract or identification number | 00400259 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $8,334 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL BENEFIT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61409 ) |
| Policy contract number | 0990358 A,B,C |
| Policy instance | 1 |
| Insurance contract or identification number | 0990358 A,B,C | | Number of Individuals Covered | 212 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,601 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,478 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 0001009730400 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001009730400 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,447 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,179 | | Insurance broker organization code? | 3 | | Insurance broker name | NIA GROUP LLC |
|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
| Policy contract number | 376210 |
| Policy instance | 5 |
| Insurance contract or identification number | 376210 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $26,093 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $435,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,093 | | Insurance broker organization code? | 3 | | Insurance broker name | THE NIA GROUP LLC DBA KORNREICH NIA |
|
| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) |
| Policy contract number | 376210 |
| Policy instance | 4 |
| Insurance contract or identification number | 376210 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $82,628 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,367,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $82,628 | | Insurance broker organization code? | 3 | | Insurance broker name | THE NIA GROUP LLC DBA KORNREICH NIA |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00400259 |
| Policy instance | 3 |
| Insurance contract or identification number | 00400259 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,959 | | Total amount of fees paid to insurance company | USD $1,942 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,959 | | Amount paid for insurance broker fees | 1942 | | Insurance broker organization code? | 3 | | Insurance broker name | NIA GROUP LLC |
|
| STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
| Policy contract number | 9736422 |
| Policy instance | 2 |
| Insurance contract or identification number | 9736422 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $888 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $888 | | Insurance broker organization code? | 3 | | Insurance broker name | NIA GROUP LLC |
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| NATIONAL BENEFIT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61409 ) |
| Policy contract number | 0990358 A,B,C |
| Policy instance | 1 |
| Insurance contract or identification number | 0990358 A,B,C | | Number of Individuals Covered | 215 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,595 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,967 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,595 | | Insurance broker organization code? | 3 | | Insurance broker name | THE NIA GROUP LLC |
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| LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
| Policy contract number | 00001009730300 |
| Policy instance | 7 |
| Insurance contract or identification number | 00001009730300 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $3,068 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DIMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $51,749 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $851 | | Insurance broker organization code? | 3 | | Insurance broker name | NIA GROUP LLC |
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