HAUG PARTNERS LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FROMMER LAWRENCE & HAUG LLP BENEFIT PLAN
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0913856 |
Policy instance | 7 |
Insurance contract or identification number | 0913856 | Number of Individuals Covered | 150 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $9,135 | Total amount of fees paid to insurance company | USD $2,588 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $90,892 | Commission paid to Insurance Broker | USD $8,999 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2588 | Additional information about fees paid to insurance broker | BONUS AMOUNT |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0242329 |
Policy instance | 1 |
Insurance contract or identification number | 0242329 | Number of Individuals Covered | 143 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $50,812 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,470,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,812 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 86 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $25,383 | Total amount of fees paid to insurance company | USD $3,261 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $169,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,383 | Amount paid for insurance broker fees | 3261 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 24 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,166 | Total amount of fees paid to insurance company | USD $649 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $21,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,166 | Amount paid for insurance broker fees | 649 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 4 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 7 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $153 | Total amount of fees paid to insurance company | USD $30 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,528 | Commission paid to Insurance Broker | USD $153 | Amount paid for insurance broker fees | 30 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 5 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 13 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $802 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,348 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $591 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | R0573956 |
Policy instance | 6 |
Insurance contract or identification number | R0573956 | Number of Individuals Covered | 13 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $802 | Other welfare benefits provided | GCI EE/I STDPROTECT | Welfare Benefit Premiums Paid to Carrier | USD $5,348 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $591 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0242329 |
Policy instance | 1 |
Insurance contract or identification number | 0242329 | Number of Individuals Covered | 154 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $62,163 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,263,798 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,086 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 87 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $24,873 | Total amount of fees paid to insurance company | USD $7,369 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $165,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,746 | Amount paid for insurance broker fees | 405 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 27 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,235 | Total amount of fees paid to insurance company | USD $977 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $21,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,513 | Amount paid for insurance broker fees | 55 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 4 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 9 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $254 | Total amount of fees paid to insurance company | USD $76 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $194 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 76 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 5 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 61 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,351 | Total amount of fees paid to insurance company | USD $1,528 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,755 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,500 | Amount paid for insurance broker fees | 75 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | R0573956 |
Policy instance | 6 |
Insurance contract or identification number | R0573956 | Number of Individuals Covered | 15 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $946 | Other welfare benefits provided | GCI EE/I STDPROTECT | Welfare Benefit Premiums Paid to Carrier | USD $6,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $894 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0913856 |
Policy instance | 7 |
Insurance contract or identification number | 0913856 | Number of Individuals Covered | 113 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $14,704 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $95,869 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,569 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0242329 |
Policy instance | 1 |
Insurance contract or identification number | 0242329 | Number of Individuals Covered | 173 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $73,522 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,641,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $13,944 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 97 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $25,895 | Total amount of fees paid to insurance company | USD $8,632 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $157,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $25,895 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 8632 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 29 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,338 | Total amount of fees paid to insurance company | USD $1,113 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $20,320 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $3,338 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1113 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 4 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 12 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $258 | Total amount of fees paid to insurance company | USD $70 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,528 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $253 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Amount paid for insurance broker fees | 70 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 5 |
Insurance contract or identification number | 656067 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 6 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 71 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,849 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,013 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $3,637 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | R0573956 |
Policy instance | 7 |
Insurance contract or identification number | R0573956 | Number of Individuals Covered | 20 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,090 | Other welfare benefits provided | GCI EE/I STDPROTECT | Welfare Benefit Premiums Paid to Carrier | USD $7,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $1,090 | Insurance broker organization code? | 3 |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL11117 |
Policy instance | 1 |
Insurance contract or identification number | FL11117 | Number of Individuals Covered | 181 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $62,916 | Total amount of fees paid to insurance company | USD $14,294 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,563,965 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Amount paid for insurance broker fees | 14294 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $62,916 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 115 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $27,291 | Total amount of fees paid to insurance company | USD $9,097 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $197,067 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $27,291 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 9097 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 30 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $3,483 | Total amount of fees paid to insurance company | USD $1,161 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $25,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $3,483 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1161 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 4 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 14 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $359 | Total amount of fees paid to insurance company | USD $263 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,522 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $352 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 263 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 5 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 91 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $3,076 | Total amount of fees paid to insurance company | USD $1,025 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,741 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Amount paid for insurance broker fees | 1025 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $3,076 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0913856 |
Policy instance | 6 |
Insurance contract or identification number | 0913856 | Number of Individuals Covered | 136 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $16,803 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $112,018 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $5,601 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | E7428725 |
Policy instance | 7 |
Insurance contract or identification number | E7428725 | Number of Individuals Covered | 6 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $187 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,358 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $187 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | R0573956 |
Policy instance | 8 |
Insurance contract or identification number | R0573956 | Number of Individuals Covered | 23 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $1,318 | Other welfare benefits provided | GCI EE/I STDPROTECT | Welfare Benefit Premiums Paid to Carrier | USD $8,783 | Commission paid to Insurance Broker | USD $1,318 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010435526 |
Policy instance | 9 |
Insurance contract or identification number | 0010435526 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Welfare Benefit Premiums Paid to Carrier | USD $550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 38 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $3,489 | Total amount of fees paid to insurance company | USD $1,163 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $23,260 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,489 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1163 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 4 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 23 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $536 | Total amount of fees paid to insurance company | USD $245 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $525 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 245 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 5 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 99 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $2,314 | Total amount of fees paid to insurance company | USD $771 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,426 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 771 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $2,314 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0913856 |
Policy instance | 6 |
Insurance contract or identification number | 0913856 | Number of Individuals Covered | 127 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $17,412 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $116,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,325 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | E7428725 |
Policy instance | 7 |
Insurance contract or identification number | E7428725 | Number of Individuals Covered | 6 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $171 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,099 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $171 | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 122 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $18,908 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $192,722 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,908 | Insurance broker organization code? | 3 |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL11117 |
Policy instance | 1 |
Insurance contract or identification number | FL11117 | Number of Individuals Covered | 190 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of fees paid to insurance company | USD $14,994 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,674,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 10066 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 6 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 103 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $1,167 | Total amount of fees paid to insurance company | USD $389 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,781 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 389 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $1,167 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL11117 |
Policy instance | 1 |
Insurance contract or identification number | FL11117 | Number of Individuals Covered | 192 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $58,392 | Total amount of fees paid to insurance company | USD $14,386 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,452,761 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,392 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 14386 | Insurance broker name | CENTERSTONE INS & FINANCIAL SVCS |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 126 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $25,068 | Total amount of fees paid to insurance company | USD $8,356 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $167,117 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,068 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 8356 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 39 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $3,396 | Total amount of fees paid to insurance company | USD $1,132 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $22,642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1132 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $3,396 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0865823 |
Policy instance | 4 |
Insurance contract or identification number | 0865823 | Number of Individuals Covered | 210 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $15,990 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,329 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 5 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 34 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $625 | Total amount of fees paid to insurance company | USD $284 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,132 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $613 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 284 | Insurance broker name | GA SOLUTIONS LLC |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL11117 |
Policy instance | 1 |
Insurance contract or identification number | FL11117 | Number of Individuals Covered | 214 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $67,433 | Total amount of fees paid to insurance company | USD $17,486 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,831,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $67,433 | Amount paid for insurance broker fees | 17486 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION PAYMENTS | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 133 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $21,474 | Total amount of fees paid to insurance company | USD $7,158 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $131,589 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,474 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 7158 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 39 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $3,039 | Total amount of fees paid to insurance company | USD $1,013 | Other welfare benefits provided | LIFESTYLE ADD & LIFESTYLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $20,256 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1013 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $3,039 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0865823 |
Policy instance | 4 |
Insurance contract or identification number | 0865823 | Number of Individuals Covered | 234 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $16,288 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $110,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,429 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 656067 |
Policy instance | 6 |
Insurance contract or identification number | 656067 | Number of Individuals Covered | 104 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $1,525 | Total amount of fees paid to insurance company | USD $408 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 408 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $1,525 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00496659 |
Policy instance | 5 |
Insurance contract or identification number | 00496659 | Number of Individuals Covered | 54 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $808 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,923 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $792 | Insurance broker organization code? | 3 | Insurance broker name | NMP PLANNING CO., INC. |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL11117 |
Policy instance | 1 |
Insurance contract or identification number | FL11117 | Number of Individuals Covered | 233 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $66,524 | Total amount of fees paid to insurance company | USD $16,912 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,632,506 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66,524 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION PAYMENTS | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 16912 | Insurance broker name | CENTERSTONE INS & FINANCIAL SVCS |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 2 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 131 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $19,086 | Total amount of fees paid to insurance company | USD $6,362 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $138,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,086 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 6362 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 3 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 41 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $11,002 | Total amount of fees paid to insurance company | USD $854 | Other welfare benefits provided | LIFESTYLE ADD & LIFE INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $17,076 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 854 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $11,002 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0865823 |
Policy instance | 4 |
Insurance contract or identification number | 0865823 | Number of Individuals Covered | 247 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $16,135 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $115,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $558 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 000496659 |
Policy instance | 5 |
Insurance contract or identification number | 000496659 | Number of Individuals Covered | 46 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $903 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $840 | Insurance broker name | NMP PLANNING CO., INC. |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3335702 |
Policy instance | 1 |
Insurance contract or identification number | 3335702 | Number of Individuals Covered | 138 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $100,984 | Total amount of fees paid to insurance company | USD $3,458 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,886,463 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $100,984 | Amount paid for insurance broker fees | 3458 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION PAYMENTS | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 4 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 30 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of fees paid to insurance company | USD $1,056 | Other welfare benefits provided | LIFESTYLE LIFE INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $21,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1056 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224192 |
Policy instance | 3 |
Insurance contract or identification number | 224192 | Number of Individuals Covered | 154 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $24,025 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,025 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 30016971 |
Policy instance | 2 |
Insurance contract or identification number | 30016971 | Number of Individuals Covered | 48 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $693 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,853 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 693 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL,INC. |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3335702 |
Policy instance | 1 |
Insurance contract or identification number | 3335702 | Number of Individuals Covered | 153 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $78,940 | Total amount of fees paid to insurance company | USD $59,470 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,973,489 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $78,940 | Amount paid for insurance broker fees | 20000 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | Insurance broker organization code? | 3 | Insurance broker name | CENTERSTONE INS & FIN SERV |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 30016971 |
Policy instance | 3 |
Insurance contract or identification number | 30016971 | Number of Individuals Covered | 60 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $744 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $744 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL,INC. |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224191 |
Policy instance | 5 |
Insurance contract or identification number | 224191 | Number of Individuals Covered | 36 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of fees paid to insurance company | USD $1,008 | Other welfare benefits provided | LIFESTYLE LIFE INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $20,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1008 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 000000224192 |
Policy instance | 4 |
Insurance contract or identification number | 000000224192 | Number of Individuals Covered | 170 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $24,314 | Total amount of fees paid to insurance company | USD $8,105 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $162,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,314 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 8105 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker name | FIDUCIARY INTERMEDIARY LTD |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 472297 |
Policy instance | 2 |
Insurance contract or identification number | 472297 | Number of Individuals Covered | 346 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $14,432 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $145,500 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,432 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 000000224192 |
Policy instance | 4 |
Insurance contract or identification number | 000000224192 | Number of Individuals Covered | 174 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $23,426 | Total amount of fees paid to insurance company | USD $7,809 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $156,172 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 30016971 |
Policy instance | 3 |
Insurance contract or identification number | 30016971 | Number of Individuals Covered | 60 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $744 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,890 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 472297 |
Policy instance | 2 |
Insurance contract or identification number | 472297 | Number of Individuals Covered | 344 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $-5,728 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $123,970 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL1125 |
Policy instance | 1 |
Insurance contract or identification number | FL1125 | Number of Individuals Covered | 330 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $85,119 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,708,027 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
Policy contract number | SYK600079 |
Policy instance | 4 |
Insurance contract or identification number | SYK600079 | Number of Individuals Covered | 160 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,821 | Total amount of fees paid to insurance company | USD $232 | Other welfare benefits provided | MEDICAL INDEMNITY/ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $12,140 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,821 | Amount paid for insurance broker fees | 232 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 472297 |
Policy instance | 3 |
Insurance contract or identification number | 472297 | Number of Individuals Covered | 322 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $13,226 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $131,695 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,226 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
Policy contract number | SGN600230 |
Policy instance | 2 |
Insurance contract or identification number | SGN600230 | Number of Individuals Covered | 160 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $11,038 | Total amount of fees paid to insurance company | USD $1,307 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,584 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,038 | Amount paid for insurance broker fees | 1307 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | FL1125 |
Policy instance | 1 |
Insurance contract or identification number | FL1125 | Number of Individuals Covered | 313 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $82,074 | Total amount of fees paid to insurance company | USD $3,150 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,656,183 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82,074 | Amount paid for insurance broker fees | 3150 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL, INC. |
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CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
Policy contract number | SGE600108 |
Policy instance | 6 |
Insurance contract or identification number | SGE600108 | Number of Individuals Covered | 160 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $11,938 | Total amount of fees paid to insurance company | USD $1,531 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,592 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,938 | Amount paid for insurance broker fees | 1531 | Additional information about fees paid to insurance broker | OVERRIDE | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE CARE INTERNATIONAL |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) |
Policy contract number | 30016971 |
Policy instance | 5 |
Insurance contract or identification number | 30016971 | Number of Individuals Covered | 51 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $712 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $712 | Insurance broker name | CORPORATE CARE INTERNATIONAL,INC. |
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