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NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 401k Plan overview

Plan NameNATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN
Plan identification number 501

NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 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
  • Other welfare benefit cover

401k Sponsoring company profile

NATIONAL INSPECTION SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:NATIONAL INSPECTION SERVICES, LLC
Employer identification number (EIN):201941802
NAIC Classification:541380
NAIC Description:Testing Laboratories

Additional information about NATIONAL INSPECTION SERVICES, LLC

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2015-05-29
Company Identification Number: 0802223841
Legal Registered Office Address: 110 HAROLD GAUTHE RD

SCOTT
United States of America (USA)
70583

More information about NATIONAL INSPECTION SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01NEIL MARKS2024-07-30 NEIL MARKS2024-07-30
5012022-01-01NEIL MARKS2023-08-16 NEIL MARKS2023-08-16
5012021-01-01NEIL MARKS2022-07-25 NEIL MARKS2022-07-25
5012020-01-01NEIL MARKS2021-06-09 NEIL MARKS2021-06-09
5012019-01-01NEIL MARKS2020-08-25 NEIL MARKS2020-08-25
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01

Plan Statistics for NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN

401k plan membership statisitcs for NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN

Measure Date Value
2023: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01141
Total number of active participants reported on line 7a of the Form 55002023-01-01141
Total of all active and inactive participants2023-01-01141
2022: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01105
Total number of active participants reported on line 7a of the Form 55002022-01-01105
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01105
2021: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01174
Total number of active participants reported on line 7a of the Form 55002021-01-01174
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01174
2020: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01247
Total number of active participants reported on line 7a of the Form 55002020-01-01247
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01247
2019: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01255
Total number of active participants reported on line 7a of the Form 55002019-01-01255
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01255
2018: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01217
Total number of active participants reported on line 7a of the Form 55002018-01-01217
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01217
2017: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01172
Total number of active participants reported on line 7a of the Form 55002017-01-01172
Total of all active and inactive participants2017-01-01172
2016: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01180
Total number of active participants reported on line 7a of the Form 55002016-01-01180
Total of all active and inactive participants2016-01-01180
2015: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01169
Total number of active participants reported on line 7a of the Form 55002015-01-01169
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01169
2014: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01148
Total number of active participants reported on line 7a of the Form 55002014-01-01148
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01148

Form 5500 Responses for NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN

2023: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NATIONAL INSPECTION SERVICES, LLC CAFETERIA PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered95
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $5,861
Total amount of fees paid to insurance companyUSD $1,698
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78P55ERC
Policy instance 3
Insurance contract or identification number78P55ERC
Number of Individuals Covered91
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $26,432
Total amount of fees paid to insurance companyUSD $3,008
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004207
Policy instance 2
Insurance contract or identification number004207
Number of Individuals Covered141
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $472
Total amount of fees paid to insurance companyUSD $181
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered43
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $9,510
Total amount of fees paid to insurance companyUSD $156
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $48,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered61
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $13,878
Total amount of fees paid to insurance companyUSD $503
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $81,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,603
Amount paid for insurance broker fees178
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004207
Policy instance 2
Insurance contract or identification number004207
Number of Individuals Covered162
Insurance policy start date2021-06-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $624
Total amount of fees paid to insurance companyUSD $514
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $518
Amount paid for insurance broker fees188
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78P55ERC
Policy instance 3
Insurance contract or identification number78P55ERC
Number of Individuals Covered103
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $34,577
Total amount of fees paid to insurance companyUSD $6,303
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,119
Amount paid for insurance broker fees6303
Additional information about fees paid to insurance brokerBONUSINCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered105
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $8,664
Total amount of fees paid to insurance companyUSD $1,821
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,070
Amount paid for insurance broker fees1821
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered76
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $30,283
Total amount of fees paid to insurance companyUSD $1,455
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $118,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19
Insurance broker organization code?3
Amount paid for insurance broker fees549
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004207
Policy instance 2
Insurance contract or identification number004207
Number of Individuals Covered174
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $779
Total amount of fees paid to insurance companyUSD $545
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $779
Insurance broker organization code?3
Amount paid for insurance broker fees545
Additional information about fees paid to insurance brokerSERVICE FEE
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78P55ERC
Policy instance 3
Insurance contract or identification number78P55ERC
Number of Individuals Covered121
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $45,460
Total amount of fees paid to insurance companyUSD $8,214
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,460
Amount paid for insurance broker fees8214
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered120
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $11,290
Total amount of fees paid to insurance companyUSD $3,631
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,290
Amount paid for insurance broker fees3631
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered202
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $13,134
Total amount of fees paid to insurance companyUSD $654
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $131,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,134
Amount paid for insurance broker fees654
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78P55ERC
Policy instance 3
Insurance contract or identification number78P55ERC
Number of Individuals Covered205
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $57,569
Total amount of fees paid to insurance companyUSD $2,255
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,569
Amount paid for insurance broker fees2255
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004207
Policy instance 2
Insurance contract or identification number004207
Number of Individuals Covered247
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $959
Total amount of fees paid to insurance companyUSD $217
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $959
Insurance broker organization code?3
Amount paid for insurance broker fees217
Additional information about fees paid to insurance brokerSERVICE FEE
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered110
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $31,992
Total amount of fees paid to insurance companyUSD $2,150
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $119,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,246
Amount paid for insurance broker fees787
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered219
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $14,074
Total amount of fees paid to insurance companyUSD $1,636
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $118,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,074
Amount paid for insurance broker fees1636
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78K11SBF
Policy instance 3
Insurance contract or identification number78K11SBF
Number of Individuals Covered195
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $45,200
Total amount of fees paid to insurance companyUSD $38,352
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,200
Amount paid for insurance broker fees38352
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004207
Policy instance 2
Insurance contract or identification number004207
Number of Individuals Covered255
Insurance policy start date2018-07-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $671
Total amount of fees paid to insurance companyUSD $1,005
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $671
Amount paid for insurance broker fees535
Additional information about fees paid to insurance brokerBONUS/SERVICE FEE
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered78
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $25,202
Total amount of fees paid to insurance companyUSD $516
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $82,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,808
Amount paid for insurance broker fees108
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 3
Insurance contract or identification number78C06ERC
Number of Individuals Covered217
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $10,851
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $102,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,851
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78K11SBF
Policy instance 2
Insurance contract or identification number78K11SBF
Number of Individuals Covered176
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $48,775
Total amount of fees paid to insurance companyUSD $22,915
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,775
Amount paid for insurance broker fees22915
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered55
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $9,837
Total amount of fees paid to insurance companyUSD $1,689
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $48,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,309
Amount paid for insurance broker fees603
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberJYU14
Policy instance 1
Insurance contract or identification numberJYU14
Number of Individuals Covered29
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $19,588
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $40,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,067
Insurance broker organization code?3
Insurance broker nameKEITH WILLIAM BELLE
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78K11SBF
Policy instance 2
Insurance contract or identification number78K11SBF
Number of Individuals Covered138
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $42,975
Total amount of fees paid to insurance companyUSD $2,752
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,975
Amount paid for insurance broker fees2752
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 3
Insurance contract or identification number78C06ERC
Number of Individuals Covered172
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $8,930
Total amount of fees paid to insurance companyUSD $7,932
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $96,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,930
Amount paid for insurance broker fees7932
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 4
Insurance contract or identification number78C06ERC
Number of Individuals Covered104
Insurance policy start date2014-04-01
Insurance policy end date2015-04-01
Total amount of commissions paid to insurance brokerUSD $1,564
Total amount of fees paid to insurance companyUSD $567
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,564
Amount paid for insurance broker fees567
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 3
Insurance contract or identification number78C06ERC
Number of Individuals Covered169
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,138
Total amount of fees paid to insurance companyUSD $81
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,138
Amount paid for insurance broker fees81
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 2
Insurance contract or identification number78C06ERC
Number of Individuals Covered139
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $35,570
Total amount of fees paid to insurance companyUSD $22,040
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,570
Amount paid for insurance broker fees22040
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78C06ERC
Policy instance 1
Insurance contract or identification number78C06ERC
Number of Individuals Covered133
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $7,209
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,209
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE COMPANY
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78C06ERC
Policy instance 3
Insurance contract or identification number78C06ERC
Number of Individuals Covered148
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $904
Total amount of fees paid to insurance companyUSD $48
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $904
Amount paid for insurance broker fees48
Additional information about fees paid to insurance brokerINCENTIVE/BONUS
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78C06ERC
Policy instance 2
Insurance contract or identification number78C06ERC
Number of Individuals Covered116
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $27,031
Total amount of fees paid to insurance companyUSD $17,996
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $853,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,031
Amount paid for insurance broker fees17996
Additional information about fees paid to insurance brokerINCENTIVE/BONUS
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE, INC.
SOUTHERN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60009 )
Policy contract number78C06ERC
Policy instance 1
Insurance contract or identification number78C06ERC
Number of Individuals Covered118
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $5,873
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,873
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL GULF SOUTH LTD

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