FLEXPRINT LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 983 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,059 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 14 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 30 |
Total of all active and inactive participants | 2022-01-01 | 1,103 |
2021: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-05-01 | 921 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 888 |
Number of retired or separated participants receiving benefits | 2021-05-01 | 95 |
Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
Total of all active and inactive participants | 2021-05-01 | 983 |
Number of employers contributing to the scheme | 2021-05-01 | 0 |
2020: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 848 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 890 |
Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
Total of all active and inactive participants | 2020-05-01 | 890 |
Number of employers contributing to the scheme | 2020-05-01 | 0 |
2017: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 296 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 617 |
Number of retired or separated participants receiving benefits | 2017-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-05-01 | 0 |
Total of all active and inactive participants | 2017-05-01 | 617 |
2016: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 177 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 293 |
Number of retired or separated participants receiving benefits | 2016-05-01 | 3 |
Total of all active and inactive participants | 2016-05-01 | 296 |
2015: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 133 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 135 |
Total of all active and inactive participants | 2015-05-01 | 135 |
2014: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 131 |
Total of all active and inactive participants | 2014-05-01 | 131 |
2013: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-08-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-08-01 | 118 |
Total of all active and inactive participants | 2013-08-01 | 118 |
2022: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
2022-01-01 | This submission is the final filing | No |
2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-01-01 | Plan is a collectively bargained plan | No |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2021 form 5500 responses |
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2021-05-01 | Type of plan entity | Single employer plan |
2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2021-05-01 | Plan funding arrangement – Insurance | Yes |
2021-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-05-01 | Plan benefit arrangement – Insurance | Yes |
2021-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Submission has been amended | No |
2016-05-01 | This submission is the final filing | No |
2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-05-01 | Plan is a collectively bargained plan | No |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2015: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Submission has been amended | No |
2015-05-01 | This submission is the final filing | No |
2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-05-01 | Plan is a collectively bargained plan | No |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2014: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Submission has been amended | No |
2014-05-01 | This submission is the final filing | No |
2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-05-01 | Plan is a collectively bargained plan | No |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2013: FLEXPRINT LLC EMPLOYEE WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-08-01 | Type of plan entity | Single employer plan |
2013-08-01 | First time form 5500 has been submitted | Yes |
2013-08-01 | Submission has been amended | No |
2013-08-01 | This submission is the final filing | No |
2013-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2013-08-01 | Plan is a collectively bargained plan | No |
2013-08-01 | Plan funding arrangement – Insurance | Yes |
2013-08-01 | Plan benefit arrangement – Insurance | Yes |
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 36100 |
Policy instance | 11 |
Insurance contract or identification number | 36100 | Number of Individuals Covered | 98 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $11,288 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $888,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,893 | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 438407 |
Policy instance | 1 |
Insurance contract or identification number | 438407 | Number of Individuals Covered | 905 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $31,271 | Total amount of fees paid to insurance company | USD $11,605 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $658,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,473 | Amount paid for insurance broker fees | 9656 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 302354 |
Policy instance | 2 |
Insurance contract or identification number | 302354 | Number of Individuals Covered | 107 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,822 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LEGAL | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $16,598 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,411 | Insurance broker organization code? | 4 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 438404 |
Policy instance | 3 |
Insurance contract or identification number | 438404 | Number of Individuals Covered | 408 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $12,524 | Total amount of fees paid to insurance company | USD $2,896 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $96,339 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,877 | Amount paid for insurance broker fees | 2697 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 36100 |
Policy instance | 4 |
Insurance contract or identification number | 36100 | Number of Individuals Covered | 76 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $10,844 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $347,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,735 | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 438406 |
Policy instance | 5 |
Insurance contract or identification number | 438406 | Number of Individuals Covered | 152 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $7,276 | Total amount of fees paid to insurance company | USD $860 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $48,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,137 | Amount paid for insurance broker fees | 753 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 ) |
Policy contract number | 035925 |
Policy instance | 6 |
Insurance contract or identification number | 035925 | Number of Individuals Covered | 1329 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $124,336 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,441,786 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $79,056 | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 438403 |
Policy instance | 7 |
Insurance contract or identification number | 438403 | Number of Individuals Covered | 186 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $6,531 | Total amount of fees paid to insurance company | USD $1,079 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $32,639 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,510 | Amount paid for insurance broker fees | 1076 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 438409 |
Policy instance | 8 |
Insurance contract or identification number | 438409 | Number of Individuals Covered | 157 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $12,718 | Total amount of fees paid to insurance company | USD $3,035 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $105,528 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,586 | Amount paid for insurance broker fees | 2800 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 438405 |
Policy instance | 9 |
Insurance contract or identification number | 438405 | Number of Individuals Covered | 1059 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,193 | Total amount of fees paid to insurance company | USD $1,872 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $63,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,332 | Amount paid for insurance broker fees | 1732 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 438408 |
Policy instance | 10 |
Insurance contract or identification number | 438408 | Number of Individuals Covered | 167 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6,692 | Total amount of fees paid to insurance company | USD $1,222 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | HOSPITAL | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $36,456 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,669 | Amount paid for insurance broker fees | 1219 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
Policy contract number | 438407 |
Policy instance | 1 |
Insurance contract or identification number | 438407 | Number of Individuals Covered | 725 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $15,017 | Total amount of fees paid to insurance company | USD $7,904 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $316,146 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,017 | Amount paid for insurance broker fees | 7904 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 302354 |
Policy instance | 2 |
Insurance contract or identification number | 302354 | Number of Individuals Covered | 888 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,916 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $11,248 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $958 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 438404 |
Policy instance | 3 |
Insurance contract or identification number | 438404 | Number of Individuals Covered | 873 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $19,971 | Total amount of fees paid to insurance company | USD $6,145 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $153,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,971 | Amount paid for insurance broker fees | 6145 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 36100 |
Policy instance | 4 |
Insurance contract or identification number | 36100 | Number of Individuals Covered | 92 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $16,835 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $1,251,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,835 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 438406 |
Policy instance | 5 |
Insurance contract or identification number | 438406 | Number of Individuals Covered | 152 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $10,573 | Total amount of fees paid to insurance company | USD $1,983 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS,HOSPITAL,ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $59,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,573 | Amount paid for insurance broker fees | 1983 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BQGV |
Policy instance | 5 |
Insurance contract or identification number | GLUG0BQGV | Number of Individuals Covered | 890 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $28,136 | Total amount of fees paid to insurance company | USD $46,933 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $281,360 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,136 | Amount paid for insurance broker fees | 18179 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 214968 |
Policy instance | 4 |
Insurance contract or identification number | 214968 | Number of Individuals Covered | 1269 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $39,006 | Total amount of fees paid to insurance company | USD $4,242 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CRITICAL ILLNESS,HOSPITAL,ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $654,421 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,362 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 36100 |
Policy instance | 3 |
Insurance contract or identification number | 36100 | Number of Individuals Covered | 196 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $15,481 | Total amount of fees paid to insurance company | USD $660 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $1,161,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,678 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 9901208 |
Policy instance | 2 |
Insurance contract or identification number | 9901208 | Number of Individuals Covered | 89 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $1,128 | Total amount of fees paid to insurance company | USD $316 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $30,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,128 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30040186 |
Policy instance | 1 |
Insurance contract or identification number | 30040186 | Number of Individuals Covered | 585 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $2,151 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,140 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,151 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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MEMD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 1209 |
Policy instance | 4 |
Insurance contract or identification number | 1209 | Number of Individuals Covered | 268 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $816 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $816 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | UNKNOWN |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05489257 |
Policy instance | 3 |
Insurance contract or identification number | TS05489257 | Number of Individuals Covered | 741 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $8,442 | Total amount of fees paid to insurance company | USD $5,079 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $177,957 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,712 | Amount paid for insurance broker fees | 4836 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | CENTERSTONE INS. AND FINANCIAL SVCS |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 2 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 298 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $18,900 | Total amount of fees paid to insurance company | USD $1,864 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $1,188,857 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,900 | Amount paid for insurance broker fees | 1864 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOVITT AND TOUCHE, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30040186 |
Policy instance | 1 |
Insurance contract or identification number | 30040186 | Number of Individuals Covered | 213 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $1,267 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $25,374 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,267 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT AND TOUCHE, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30040186 |
Policy instance | 1 |
Insurance contract or identification number | 30040186 | Number of Individuals Covered | 100 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $838 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $838 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 2 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 144 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $1,931 | Total amount of fees paid to insurance company | USD $427 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $12,873 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,931 | Amount paid for insurance broker fees | 427 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0517753SL |
Policy instance | 3 |
Insurance contract or identification number | 0517753SL | Number of Individuals Covered | 134 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $173,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05489257 |
Policy instance | 4 |
Insurance contract or identification number | TS05489257 | Number of Individuals Covered | 177 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $5,882 | Total amount of fees paid to insurance company | USD $3,308 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,154 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,176 | Amount paid for insurance broker fees | 1884 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | CENTERSTONE INS AND FIN SVCS |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30040186 |
Policy instance | 1 |
Insurance contract or identification number | 30040186 | Number of Individuals Covered | 101 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $808 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $808 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 2 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 153 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $2,487 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,487 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 3 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 153 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $1,480 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,869 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,480 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 4 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 153 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $1,740 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,740 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05489257 |
Policy instance | 6 |
Insurance contract or identification number | TS05489257 | Number of Individuals Covered | 344 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $11,666 | Total amount of fees paid to insurance company | USD $976 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,509 | Amount paid for insurance broker fees | 176 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PG INS SERVICES INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0517753SL |
Policy instance | 5 |
Insurance contract or identification number | 0517753SL | Number of Individuals Covered | 134 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $268,407 | 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: 39616 ) |
Policy contract number | 30040186 |
Policy instance | 1 |
Insurance contract or identification number | 30040186 | Number of Individuals Covered | 84 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $674 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,472 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $674 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05489257 |
Policy instance | 6 |
Insurance contract or identification number | TS05489257 | Number of Individuals Covered | 321 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $1,768 | Total amount of fees paid to insurance company | USD $231 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,848 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,805 | Amount paid for insurance broker fees | 231 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PG INS SERVICES INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0517753 |
Policy instance | 5 |
Insurance contract or identification number | 0517753 | Number of Individuals Covered | 208 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $20,156 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $493,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,254 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 4 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 134 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $1,332 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,332 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 3 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 134 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $1,111 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,028 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,111 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228848 |
Policy instance | 2 |
Insurance contract or identification number | 228848 | Number of Individuals Covered | 134 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $1,865 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,472 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,865 | Insurance broker organization code? | 3 | Insurance broker name | LOVITT TOUCHE INC |
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