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GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 401k Plan overview

Plan NameGROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC.
Plan identification number 501

GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. Benefits

401k Plan TypeWelfare 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)
  • Other welfare benefit cover

401k Sponsoring company profile

ATALIAN GLOBAL SERVICES INC, has sponsored the creation of one or more 401k plans.

Company Name:ATALIAN GLOBAL SERVICES INC,
Employer identification number (EIN):132622538
NAIC Classification:561720
NAIC Description:Janitorial Services

Additional information about ATALIAN GLOBAL SERVICES INC,

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0689014

More information about ATALIAN GLOBAL SERVICES INC,

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01ARRON K RHODES2022-10-21
5012020-07-01ARRON K RHODES2022-01-14
5012019-07-01CAROL LOPERA2021-01-05
5012018-07-01CAROL LOPERA2020-02-27
5012017-07-01CAROL LOPERA
5012016-07-01LLOYD DE FRANCE
5012015-07-01LLOYD DE FRANCE LLOYD DE FRANCE2017-01-26
5012014-07-01LLOYD DEFRANCE LLOYD DEFRANCE2016-01-27
5012013-07-01LLOYD DEFRANCE LLOYD DEFRANCE2015-01-23
5012012-07-01LLOYD DEFRANCE LLOYD DEFRANCE2014-01-30
5012011-07-01LLOYD DEFRANCE LLOYD DE FRANCE2013-01-30
5012010-07-01LLOYD DEFRANCE
5012009-07-01LLOYD DE FRANCE LLOYD DE FRANCE2011-01-24

Plan Statistics for GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC.

401k plan membership statisitcs for GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC.

Measure Date Value
2021: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2021 401k membership
Total participants, beginning-of-year2021-07-01413
Total number of active participants reported on line 7a of the Form 55002021-07-01295
Number of retired or separated participants receiving benefits2021-07-012
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01297
Number of employers contributing to the scheme2021-07-010
2020: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2020 401k membership
Total participants, beginning-of-year2020-07-01524
Total number of active participants reported on line 7a of the Form 55002020-07-01413
Number of retired or separated participants receiving benefits2020-07-011
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01414
Number of employers contributing to the scheme2020-07-010
2019: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2019 401k membership
Total participants, beginning-of-year2019-07-01563
Total number of active participants reported on line 7a of the Form 55002019-07-01497
Number of retired or separated participants receiving benefits2019-07-017
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01504
Number of employers contributing to the scheme2019-07-010
2018: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2018 401k membership
Total participants, beginning-of-year2018-07-01533
Total number of active participants reported on line 7a of the Form 55002018-07-01562
Number of retired or separated participants receiving benefits2018-07-011
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01563
Number of employers contributing to the scheme2018-07-010
2017: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2017 401k membership
Total participants, beginning-of-year2017-07-01267
Total number of active participants reported on line 7a of the Form 55002017-07-01188
Number of retired or separated participants receiving benefits2017-07-019
Number of other retired or separated participants entitled to future benefits2017-07-0136
Total of all active and inactive participants2017-07-01233
2016: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2016 401k membership
Total participants, beginning-of-year2016-07-01218
Total number of active participants reported on line 7a of the Form 55002016-07-01196
Number of retired or separated participants receiving benefits2016-07-013
Number of other retired or separated participants entitled to future benefits2016-07-0168
Total of all active and inactive participants2016-07-01267
2015: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2015 401k membership
Total participants, beginning-of-year2015-07-01228
Total number of active participants reported on line 7a of the Form 55002015-07-01208
Number of retired or separated participants receiving benefits2015-07-013
Number of other retired or separated participants entitled to future benefits2015-07-017
Total of all active and inactive participants2015-07-01218
2014: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2014 401k membership
Total participants, beginning-of-year2014-07-01215
Total number of active participants reported on line 7a of the Form 55002014-07-01216
Number of retired or separated participants receiving benefits2014-07-019
Number of other retired or separated participants entitled to future benefits2014-07-013
Total of all active and inactive participants2014-07-01228
2013: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2013 401k membership
Total participants, beginning-of-year2013-07-012,187
Total number of active participants reported on line 7a of the Form 55002013-07-01202
Number of retired or separated participants receiving benefits2013-07-019
Number of other retired or separated participants entitled to future benefits2013-07-014
Total of all active and inactive participants2013-07-01215
2012: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2012 401k membership
Total participants, beginning-of-year2012-07-013,416
Total number of active participants reported on line 7a of the Form 55002012-07-012,187
Number of retired or separated participants receiving benefits2012-07-016
Number of other retired or separated participants entitled to future benefits2012-07-014
Total of all active and inactive participants2012-07-012,197
2011: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2011 401k membership
Total participants, beginning-of-year2011-07-013,199
Total number of active participants reported on line 7a of the Form 55002011-07-013,406
Number of retired or separated participants receiving benefits2011-07-016
Number of other retired or separated participants entitled to future benefits2011-07-014
Total of all active and inactive participants2011-07-013,416
2010: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2010 401k membership
Total participants, beginning-of-year2010-07-013,424
Total number of active participants reported on line 7a of the Form 55002010-07-013,195
Number of retired or separated participants receiving benefits2010-07-014
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-013,199
2009: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2009 401k membership
Total participants, beginning-of-year2009-07-013,354
Total number of active participants reported on line 7a of the Form 55002009-07-013,408
Number of retired or separated participants receiving benefits2009-07-0112
Number of other retired or separated participants entitled to future benefits2009-07-014
Total of all active and inactive participants2009-07-013,424

Form 5500 Responses for GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC.

2021: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planYes
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planYes
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planYes
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planYes
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2013 form 5500 responses
2013-07-01Type of plan entityMulti-employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planYes
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2012 form 5500 responses
2012-07-01Type of plan entityMulti-employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planYes
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2011 form 5500 responses
2011-07-01Type of plan entityMulti-employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planYes
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2010 form 5500 responses
2010-07-01Type of plan entityMulti-employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planYes
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: GROUP DISABILITY AND SUPPLEMENTAL MEDICAL PLAN FOR TEMCO SERVICE INDUSTRIES, INC. 2009 form 5500 responses
2009-07-01Type of plan entityMulti-employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planYes
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL160879
Policy instance 4
Insurance contract or identification numberGL160879
Number of Individuals Covered212
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $49,114
Total amount of fees paid to insurance companyUSD $12,691
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $233,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,400
Amount paid for insurance broker fees7306
Additional information about fees paid to insurance brokerTOTAL ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number137-001033
Policy instance 3
Insurance contract or identification number137-001033
Number of Individuals Covered407
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $2,720
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,720
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5369882
Policy instance 2
Insurance contract or identification number5369882
Number of Individuals Covered318
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $15,754
Total amount of fees paid to insurance companyUSD $6,966
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,754
Amount paid for insurance broker fees3151
Additional information about fees paid to insurance brokerTHIRD PARTY ADMINISTRATION FEES
Insurance broker organization code?5
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908538
Policy instance 1
Insurance contract or identification number908538
Number of Individuals Covered295
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $72,568
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,346,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,568
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5369882
Policy instance 2
Insurance contract or identification number5369882
Number of Individuals Covered399
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $20,460
Total amount of fees paid to insurance companyUSD $8,173
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $136,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,460
Amount paid for insurance broker fees4093
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908538
Policy instance 1
Insurance contract or identification number908538
Number of Individuals Covered341
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $94,452
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,136,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $94,452
Amount paid for insurance broker fees0
Insurance broker organization code?3
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number137-001033
Policy instance 3
Insurance contract or identification number137-001033
Number of Individuals Covered488
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $3,696
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,696
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL160879
Policy instance 4
Insurance contract or identification numberGL160879
Number of Individuals Covered306
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $66,911
Total amount of fees paid to insurance companyUSD $4,828
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $301,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,423
Amount paid for insurance broker fees3545
Additional information about fees paid to insurance brokerTOTAL ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL160879
Policy instance 6
Insurance contract or identification numberGL160879
Number of Individuals Covered392
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $77,114
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $280,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,064
Amount paid for insurance broker fees0
Insurance broker organization code?3
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number137-001033
Policy instance 5
Insurance contract or identification number137-001033
Number of Individuals Covered633
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $3,242
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,242
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )
Policy contract numberE7922917
Policy instance 4
Insurance contract or identification numberE7922917
Number of Individuals Covered13
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $246
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY WORKSITE BENEFITS
Welfare Benefit Premiums Paid to CarrierUSD $1,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $159
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5369882
Policy instance 3
Insurance contract or identification number5369882
Number of Individuals Covered529
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $25,338
Total amount of fees paid to insurance companyUSD $10,263
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $168,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,338
Amount paid for insurance broker fees5069
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?5
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number409924 0001
Policy instance 2
Insurance contract or identification number409924 0001
Number of Individuals Covered194
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,938
Total amount of fees paid to insurance companyUSD $194
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,938
Amount paid for insurance broker fees194
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908538
Policy instance 1
Insurance contract or identification number908538
Number of Individuals Covered504
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $123,462
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,106,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $123,960
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLI960256
Policy instance 8
Insurance contract or identification numberFLI960256
Number of Individuals Covered562
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $6,603
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $44,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,592
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )
Policy contract numberE7922917
Policy instance 7
Insurance contract or identification numberE7922917
Number of Individuals Covered14
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,571
Total amount of fees paid to insurance companyUSD $3
Other welfare benefits providedVOLUNTARY WORKSITE BENEFITS
Welfare Benefit Premiums Paid to CarrierUSD $22,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $345
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number926625
Policy instance 6
Insurance contract or identification number926625
Number of Individuals Covered645
Insurance policy start date2019-01-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $2,255
Total amount of fees paid to insurance companyUSD $2,668
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,255
Amount paid for insurance broker fees2668
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5277047
Policy instance 5
Insurance contract or identification number5277047
Number of Individuals Covered598
Insurance policy start date2018-07-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,441
Total amount of fees paid to insurance companyUSD $5,413
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,441
Amount paid for insurance broker fees5413
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number883982
Policy instance 4
Insurance contract or identification number883982
Number of Individuals Covered622
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $17,513
Total amount of fees paid to insurance companyUSD $101
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $17,513
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number409924
Policy instance 3
Insurance contract or identification number409924
Number of Individuals Covered206
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $11,217
Total amount of fees paid to insurance companyUSD $1,402
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $119,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,217
Amount paid for insurance broker fees1402
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number10074481001
Policy instance 2
Insurance contract or identification number10074481001
Number of Individuals Covered511
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $2,027
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,936
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908538
Policy instance 1
Insurance contract or identification number908538
Number of Individuals Covered556
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $104,122
Total amount of fees paid to insurance companyUSD $2,420
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,670,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93,450
Amount paid for insurance broker fees2420
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7922917*
Policy instance 2
Insurance contract or identification numberE7922917*
Number of Individuals Covered1
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $123
Total amount of fees paid to insurance companyUSD $1
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY WORKSITE BENEFITS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number1007448
Policy instance 3
Insurance contract or identification number1007448
Number of Individuals Covered146
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,160
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number409924*
Policy instance 4
Insurance contract or identification number409924*
Number of Individuals Covered896
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $17,221
Total amount of fees paid to insurance companyUSD $2,153
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $172,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )
Policy contract numberE7922917*
Policy instance 5
Insurance contract or identification numberE7922917*
Number of Individuals Covered16
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,973
Total amount of fees paid to insurance companyUSD $43
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOLUNTARY WORKSITE BENEFITS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number908538
Policy instance 6
Insurance contract or identification number908538
Number of Individuals Covered188
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $58,395
Total amount of fees paid to insurance companyUSD $5,014
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,808,269
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 number883982
Policy instance 1
Insurance contract or identification number883982
Number of Individuals Covered175
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $7,098
Total amount of fees paid to insurance companyUSD $642
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $69,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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