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GOODWIN, WRIGHT INC 401k Plan overview

Plan NameGOODWIN, WRIGHT INC
Plan identification number 501

GOODWIN, WRIGHT INC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

GOODWIN, WRIGHT INC has sponsored the creation of one or more 401k plans.

Company Name:GOODWIN, WRIGHT INC
Employer identification number (EIN):203678803
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOODWIN, WRIGHT INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01EDWARD KROPP2023-09-18
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01EDWARD KROPP
5012016-01-01EDWARD KROPP
5012015-01-01EDWARD KROPP EDWARD KROPP2016-07-29
5012014-01-01MARY RUSHING
5012013-01-01MARY RUSHING
5012012-01-01MARY RUSHING
5012011-01-01MARY RUSHING
5012010-01-01MARY RUSHING
5012009-01-01MARY RUSHING

Plan Statistics for GOODWIN, WRIGHT INC

401k plan membership statisitcs for GOODWIN, WRIGHT INC

Measure Date Value
2022: GOODWIN, WRIGHT INC 2022 401k membership
Total participants, beginning-of-year2022-01-01159
Total number of active participants reported on line 7a of the Form 55002022-01-01159
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 participants2022-01-01159
Number of employers contributing to the scheme2022-01-010
2021: GOODWIN, WRIGHT INC 2021 401k membership
Total participants, beginning-of-year2021-01-01151
Total number of active participants reported on line 7a of the Form 55002021-01-01159
Total of all active and inactive participants2021-01-01159
2020: GOODWIN, WRIGHT INC 2020 401k membership
Total participants, beginning-of-year2020-01-01149
Total number of active participants reported on line 7a of the Form 55002020-01-01151
Total of all active and inactive participants2020-01-01151
2019: GOODWIN, WRIGHT INC 2019 401k membership
Total participants, beginning-of-year2019-01-01273
Total number of active participants reported on line 7a of the Form 55002019-01-01149
Total of all active and inactive participants2019-01-01149
2018: GOODWIN, WRIGHT INC 2018 401k membership
Total participants, beginning-of-year2018-01-01254
Total number of active participants reported on line 7a of the Form 55002018-01-01273
Total of all active and inactive participants2018-01-01273
2017: GOODWIN, WRIGHT INC 2017 401k membership
Total participants, beginning-of-year2017-01-01254
Total number of active participants reported on line 7a of the Form 55002017-01-01254
Total of all active and inactive participants2017-01-01254
2016: GOODWIN, WRIGHT INC 2016 401k membership
Total participants, beginning-of-year2016-01-01228
Total number of active participants reported on line 7a of the Form 55002016-01-01253
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01254
2015: GOODWIN, WRIGHT INC 2015 401k membership
Total participants, beginning-of-year2015-01-01201
Total number of active participants reported on line 7a of the Form 55002015-01-01227
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-01228
2014: GOODWIN, WRIGHT INC 2014 401k membership
Total participants, beginning-of-year2014-01-01188
Total number of active participants reported on line 7a of the Form 55002014-01-01200
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-01201
2013: GOODWIN, WRIGHT INC 2013 401k membership
Total participants, beginning-of-year2013-01-01168
Total number of active participants reported on line 7a of the Form 55002013-01-01188
Total of all active and inactive participants2013-01-01188
2012: GOODWIN, WRIGHT INC 2012 401k membership
Total participants, beginning-of-year2012-01-01161
Total number of active participants reported on line 7a of the Form 55002012-01-01168
Total of all active and inactive participants2012-01-01168
2011: GOODWIN, WRIGHT INC 2011 401k membership
Total participants, beginning-of-year2011-01-01181
Total number of active participants reported on line 7a of the Form 55002011-01-01161
Total of all active and inactive participants2011-01-01161
2010: GOODWIN, WRIGHT INC 2010 401k membership
Total participants, beginning-of-year2010-01-01172
Total number of active participants reported on line 7a of the Form 55002010-01-01181
Total of all active and inactive participants2010-01-01181
2009: GOODWIN, WRIGHT INC 2009 401k membership
Total participants, beginning-of-year2009-01-01170
Total number of active participants reported on line 7a of the Form 55002009-01-01172
Total of all active and inactive participants2009-01-01172
Total participants2009-01-010

Form 5500 Responses for GOODWIN, WRIGHT INC

2022: GOODWIN, WRIGHT INC 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2020: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2019: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2018: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2017: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2016: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2015: GOODWIN, WRIGHT INC 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 benefit arrangement – InsuranceYes
2014: GOODWIN, WRIGHT INC 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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 benefit arrangement – InsuranceYes
2013: GOODWIN, WRIGHT INC 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GOODWIN, WRIGHT INC 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GOODWIN, WRIGHT INC 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GOODWIN, WRIGHT INC 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GOODWIN, WRIGHT INC 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMYIDR1503
Policy instance 1
Insurance contract or identification numberMYIDR1503
Number of Individuals Covered29
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $1,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 7
Insurance contract or identification number657869
Number of Individuals Covered162
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $23,784
Total amount of fees paid to insurance companyUSD $3,831
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $95,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,297
Amount paid for insurance broker fees276
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 2
Insurance contract or identification number10062
Number of Individuals Covered67
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $13,501
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $267,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,501
Amount paid for insurance broker fees0
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 3
Insurance contract or identification number7615644
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05959117
Policy instance 4
Insurance contract or identification numberTM05959117
Number of Individuals Covered28
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $532
Total amount of fees paid to insurance companyUSD $137
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $532
Amount paid for insurance broker fees106
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1022540
Policy instance 5
Insurance contract or identification number1022540
Number of Individuals Covered30
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $178
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $178
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877717
Policy instance 6
Insurance contract or identification number877717
Number of Individuals Covered23
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,737
Total amount of fees paid to insurance companyUSD $494
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $25,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,737
Amount paid for insurance broker fees494
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 1
Insurance contract or identification number10062
Number of Individuals Covered75
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $12,322
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $248,598
Commission paid to Insurance BrokerUSD $12,322
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0026518
Policy instance 2
Insurance contract or identification numberR0026518
Number of Individuals Covered16
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $147
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $2,920
Commission paid to Insurance BrokerUSD $147
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5959117
Policy instance 3
Insurance contract or identification number5959117
Number of Individuals Covered51
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $204
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,051
Amount paid for insurance broker fees204
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877717
Policy instance 5
Insurance contract or identification number877717
Number of Individuals Covered27
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,077
Total amount of fees paid to insurance companyUSD $1,426
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,516
Commission paid to Insurance BrokerUSD $4,077
Amount paid for insurance broker fees1426
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877717
Policy instance 6
Insurance contract or identification number877717
Number of Individuals Covered27
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,077
Total amount of fees paid to insurance companyUSD $1,426
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,516
Commission paid to Insurance BrokerUSD $4,077
Amount paid for insurance broker fees1426
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657569
Policy instance 7
Insurance contract or identification number657569
Number of Individuals Covered159
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,027
Total amount of fees paid to insurance companyUSD $991
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $27,965
Commission paid to Insurance BrokerUSD $1,678
Amount paid for insurance broker fees445
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number102254
Policy instance 8
Insurance contract or identification number102254
Number of Individuals Covered29
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $146
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,501
Commission paid to Insurance BrokerUSD $146
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1022540
Policy instance 9
Insurance contract or identification number1022540
Number of Individuals Covered29
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $146
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,501
Commission paid to Insurance BrokerUSD $146
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 4
Insurance contract or identification number7615644
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $36
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $1,423
Commission paid to Insurance BrokerUSD $10
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877717
Policy instance 7
Insurance contract or identification number877717
Number of Individuals Covered26
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,193
Total amount of fees paid to insurance companyUSD $579
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,283
Commission paid to Insurance BrokerUSD $3,193
Amount paid for insurance broker fees579
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10225401001
Policy instance 2
Insurance contract or identification number10225401001
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $149
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,543
Commission paid to Insurance BrokerUSD $149
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 3
Insurance contract or identification number7615644
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $204
Total amount of fees paid to insurance companyUSD $14
Other welfare benefits providedACCDENT
Welfare Benefit Premiums Paid to CarrierUSD $4,265
Commission paid to Insurance BrokerUSD $19
Insurance broker organization code?3
Amount paid for insurance broker fees14
Additional information about fees paid to insurance brokerBONUS
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 4
Insurance contract or identification number10062
Number of Individuals Covered82
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,252
Total amount of fees paid to insurance companyUSD $47
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $224,582
Commission paid to Insurance BrokerUSD $11,252
Amount paid for insurance broker fees47
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877716
Policy instance 5
Insurance contract or identification number877716
Number of Individuals Covered151
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,499
Total amount of fees paid to insurance companyUSD $273
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,115
Commission paid to Insurance BrokerUSD $1,499
Amount paid for insurance broker fees273
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5959117
Policy instance 6
Insurance contract or identification number5959117
Number of Individuals Covered32
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $627
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,780
Amount paid for insurance broker fees618
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0026518
Policy instance 8
Insurance contract or identification numberR0026518
Number of Individuals Covered16
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $158
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $3,130
Commission paid to Insurance BrokerUSD $158
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 9
Insurance contract or identification number657869
Number of Individuals Covered151
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,151
Total amount of fees paid to insurance companyUSD $1,185
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,876
Commission paid to Insurance BrokerUSD $2,463
Amount paid for insurance broker fees621
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877718
Policy instance 1
Insurance contract or identification number877718
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,093
Total amount of fees paid to insurance companyUSD $202
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,670
Commission paid to Insurance BrokerUSD $1,093
Amount paid for insurance broker fees202
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523001
Policy instance 1
Insurance contract or identification number152523001
Number of Individuals Covered149
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,466
Total amount of fees paid to insurance companyUSD $936
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,863
Commission paid to Insurance BrokerUSD $2,127
Amount paid for insurance broker fees936
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 2
Insurance contract or identification number7615644
Number of Individuals Covered28
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $160
Total amount of fees paid to insurance companyUSD $2
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $5,167
Commission paid to Insurance BrokerUSD $22
Insurance broker organization code?3
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerBONUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877716
Policy instance 3
Insurance contract or identification number877716
Number of Individuals Covered149
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,147
Total amount of fees paid to insurance companyUSD $382
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,648
Commission paid to Insurance BrokerUSD $1,147
Amount paid for insurance broker fees382
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5959117
Policy instance 4
Insurance contract or identification number5959117
Number of Individuals Covered41
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $74
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,191
Amount paid for insurance broker fees62
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524
Policy instance 5
Insurance contract or identification number152524
Number of Individuals Covered26
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,835
Total amount of fees paid to insurance companyUSD $384
Life Insurance Welfare BenefitYes
Other welfare benefits providedLIFESTYLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $20,485
Commission paid to Insurance BrokerUSD $2,876
Amount paid for insurance broker fees384
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877717
Policy instance 6
Insurance contract or identification number877717
Number of Individuals Covered30
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,410
Total amount of fees paid to insurance companyUSD $1,003
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,064
Commission paid to Insurance BrokerUSD $3,410
Amount paid for insurance broker fees1003
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 7
Insurance contract or identification number10062
Number of Individuals Covered48
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $30,497
Total amount of fees paid to insurance companyUSD $21
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $498,270
Commission paid to Insurance BrokerUSD $22,548
Insurance broker organization code?3
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerBONUS
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10225401001
Policy instance 8
Insurance contract or identification number10225401001
Number of Individuals Covered37
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $155
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,621
Commission paid to Insurance BrokerUSD $155
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number877718
Policy instance 9
Insurance contract or identification number877718
Number of Individuals Covered26
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,193
Total amount of fees paid to insurance companyUSD $398
Life Insurance Welfare BenefitYes
Other welfare benefits providedLIFESTYLE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $7,953
Commission paid to Insurance BrokerUSD $1,193
Amount paid for insurance broker fees398
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0026518
Policy instance 10
Insurance contract or identification numberR0026518
Number of Individuals Covered43
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $263
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $5,236
Commission paid to Insurance BrokerUSD $263
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTMO5984593
Policy instance 5
Insurance contract or identification numberTMO5984593
Number of Individuals Covered158
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,545
Total amount of fees paid to insurance companyUSD $11,152
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $222,161
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees11108
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525230003
Policy instance 4
Insurance contract or identification number1525230003
Number of Individuals Covered105
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,283
Total amount of fees paid to insurance companyUSD $435
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $23,768
Commission paid to Insurance BrokerUSD $1,197
Amount paid for insurance broker fees435
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 3
Insurance contract or identification number10062
Number of Individuals Covered334
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $69,182
Total amount of fees paid to insurance companyUSD $259
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,397,883
Commission paid to Insurance BrokerUSD $69,182
Amount paid for insurance broker fees259
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 2
Insurance contract or identification number7615644
Number of Individuals Covered32
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $498
Total amount of fees paid to insurance companyUSD $10
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $11,041
Commission paid to Insurance BrokerUSD $28
Insurance broker organization code?3
Amount paid for insurance broker fees10
Additional information about fees paid to insurance brokerBONUS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525240001
Policy instance 1
Insurance contract or identification number1525240001
Number of Individuals Covered75
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,592
Total amount of fees paid to insurance companyUSD $906
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,529
Commission paid to Insurance BrokerUSD $6,592
Amount paid for insurance broker fees906
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525240003
Policy instance 6
Insurance contract or identification number1525240003
Number of Individuals Covered24
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,337
Total amount of fees paid to insurance companyUSD $184
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,270
Commission paid to Insurance BrokerUSD $1,337
Amount paid for insurance broker fees184
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number47
Policy instance 7
Insurance contract or identification number47
Number of Individuals Covered7615644
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,214
Total amount of fees paid to insurance companyUSD $91
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $11,143
Commission paid to Insurance BrokerUSD $1,214
Amount paid for insurance broker fees91
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 8
Insurance contract or identification number657869
Number of Individuals Covered130
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,438
Total amount of fees paid to insurance companyUSD $1,046
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,426
Commission paid to Insurance BrokerUSD $2,772
Amount paid for insurance broker fees699
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523001
Policy instance 9
Insurance contract or identification number152523001
Number of Individuals Covered137
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,476
Total amount of fees paid to insurance companyUSD $1,426
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,981
Commission paid to Insurance BrokerUSD $3,911
Amount paid for insurance broker fees1426
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525230002
Policy instance 11
Insurance contract or identification number1525230002
Number of Individuals Covered31
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $874
Total amount of fees paid to insurance companyUSD $175
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,384
Commission paid to Insurance BrokerUSD $437
Amount paid for insurance broker fees175
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525240002
Policy instance 10
Insurance contract or identification number1525240002
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $140
Total amount of fees paid to insurance companyUSD $19
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $786
Commission paid to Insurance BrokerUSD $105
Amount paid for insurance broker fees14
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97258211001
Policy instance 12
Insurance contract or identification number97258211001
Number of Individuals Covered366
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,101
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,304
Commission paid to Insurance BrokerUSD $2,101
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 12
Insurance contract or identification number10062
Number of Individuals Covered304
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $63,577
Total amount of fees paid to insurance companyUSD $56
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,301,481
Commission paid to Insurance BrokerUSD $63,577
Amount paid for insurance broker fees56
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 11
Insurance contract or identification number657869
Number of Individuals Covered254
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,369
Total amount of fees paid to insurance companyUSD $1,127
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,482
Commission paid to Insurance BrokerUSD $3,295
Amount paid for insurance broker fees761
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameGOODWIN WRIGHT INC
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number97258211001
Policy instance 10
Insurance contract or identification number97258211001
Number of Individuals Covered358
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,356
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,828
Commission paid to Insurance BrokerUSD $2,356
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525230002
Policy instance 1
Insurance contract or identification number1525230002
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $789
Total amount of fees paid to insurance companyUSD $160
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,356
Commission paid to Insurance BrokerUSD $455
Amount paid for insurance broker fees160
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523001
Policy instance 2
Insurance contract or identification number152523001
Number of Individuals Covered141
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,434
Total amount of fees paid to insurance companyUSD $1,320
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $60,470
Commission paid to Insurance BrokerUSD $3,664
Amount paid for insurance broker fees1320
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05984593
Policy instance 3
Insurance contract or identification numberTM05984593
Number of Individuals Covered157
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,420
Total amount of fees paid to insurance companyUSD $10,241
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,012
Commission paid to Insurance BrokerUSD $5,420
Amount paid for insurance broker fees440
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525230003
Policy instance 4
Insurance contract or identification number1525230003
Number of Individuals Covered112
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,378
Total amount of fees paid to insurance companyUSD $470
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $21,396
Commission paid to Insurance BrokerUSD $975
Insurance broker organization code?3
Amount paid for insurance broker fees470
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0026518
Policy instance 5
Insurance contract or identification numberR0026518
Number of Individuals Covered52
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,015
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $11,708
Commission paid to Insurance BrokerUSD $1,015
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 6
Insurance contract or identification number7615644
Number of Individuals Covered36
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,186
Total amount of fees paid to insurance companyUSD $84
Other welfare benefits providedVOLUNTARY BENEFITS ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $11,855
Commission paid to Insurance BrokerUSD $45
Insurance broker organization code?3
Amount paid for insurance broker fees84
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525240002
Policy instance 7
Insurance contract or identification number1525240002
Number of Individuals Covered4
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $220
Total amount of fees paid to insurance companyUSD $23
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $1,040
Commission paid to Insurance BrokerUSD $174
Amount paid for insurance broker fees23
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524001
Policy instance 8
Insurance contract or identification number152524001
Number of Individuals Covered84
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,864
Total amount of fees paid to insurance companyUSD $610
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $28,010
Commission paid to Insurance BrokerUSD $4,578
Amount paid for insurance broker fees610
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number1525240003
Policy instance 9
Insurance contract or identification number1525240003
Number of Individuals Covered27
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,303
Total amount of fees paid to insurance companyUSD $136
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $6,201
Commission paid to Insurance BrokerUSD $1,021
Amount paid for insurance broker fees136
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLIAZON BENEFITS INC.
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 7
Insurance contract or identification number657869
Number of Individuals Covered227
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,265
Total amount of fees paid to insurance companyUSD $1,079
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,715
Commission paid to Insurance BrokerUSD $3,231
Amount paid for insurance broker fees746
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameAUBREY E VAUGHN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0026518
Policy instance 6
Insurance contract or identification numberR0026518
Number of Individuals Covered52
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $798
Total amount of fees paid to insurance companyUSD $4
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $12,325
Commission paid to Insurance BrokerUSD $798
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 5
Insurance contract or identification number7615644
Number of Individuals Covered43
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $712
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY BENEFITS ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,729
Commission paid to Insurance BrokerUSD $57
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 4
Insurance contract or identification number152523
Number of Individuals Covered233
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,111
Total amount of fees paid to insurance companyUSD $1,365
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $76,123
Commission paid to Insurance BrokerUSD $4,111
Amount paid for insurance broker fees1365
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524
Policy instance 2
Insurance contract or identification number152524
Number of Individuals Covered99
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,628
Total amount of fees paid to insurance companyUSD $484
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $24,171
Commission paid to Insurance BrokerUSD $3,628
Amount paid for insurance broker fees484
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9725821
Policy instance 1
Insurance contract or identification number9725821
Number of Individuals Covered255
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,297
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,346
Commission paid to Insurance BrokerUSD $1,297
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05984593
Policy instance 8
Insurance contract or identification numberTM05984593
Number of Individuals Covered181
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,281
Total amount of fees paid to insurance companyUSD $7,258
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $146,282
Commission paid to Insurance BrokerUSD $4,281
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker nameLIAZON BENEFITS INC.
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 3
Insurance contract or identification number10062
Number of Individuals Covered217
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $43,472
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $957,473
Commission paid to Insurance BrokerUSD $43,472
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524
Policy instance 3
Insurance contract or identification number152524
Number of Individuals Covered74
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,065
Total amount of fees paid to insurance companyUSD $542
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $27,097
Commission paid to Insurance BrokerUSD $4,065
Amount paid for insurance broker fees542
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 5
Insurance contract or identification number657869
Number of Individuals Covered98
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,177
Total amount of fees paid to insurance companyUSD $1,000
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,581
Commission paid to Insurance BrokerUSD $4,032
Amount paid for insurance broker fees839
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameAUBREY E VAUGHN
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 4
Insurance contract or identification number7615644
Number of Individuals Covered49
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,250
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY BENEFITS ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,613
Commission paid to Insurance BrokerUSD $61
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9725821
Policy instance 2
Insurance contract or identification number9725821
Number of Individuals Covered188
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $945
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,617
Commission paid to Insurance BrokerUSD $945
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 6
Insurance contract or identification number10062
Number of Individuals Covered175
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $43,763
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $875,249
Commission paid to Insurance BrokerUSD $43,763
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05984593
Policy instance 7
Insurance contract or identification numberTM05984593
Number of Individuals Covered482
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,755
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,644
Commission paid to Insurance BrokerUSD $3,755
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 1
Insurance contract or identification number152523
Number of Individuals Covered201
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,198
Total amount of fees paid to insurance companyUSD $1,787
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $89,340
Commission paid to Insurance BrokerUSD $5,198
Amount paid for insurance broker fees1787
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract numberR0026518
Policy instance 8
Insurance contract or identification numberR0026518
Number of Individuals Covered56
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,633
Total amount of fees paid to insurance companyUSD $164
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $20,196
Commission paid to Insurance BrokerUSD $1,633
Amount paid for insurance broker fees164
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number7615644
Policy instance 7
Insurance contract or identification number7615644
Number of Individuals Covered34
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,443
Total amount of fees paid to insurance companyUSD $32
Other welfare benefits providedVOLUNTARY BENEFITS ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $9,289
Commission paid to Insurance BrokerUSD $72
Insurance broker organization code?3
Amount paid for insurance broker fees32
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05984593
Policy instance 2
Insurance contract or identification numberTM05984593
Number of Individuals Covered455
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract numberR0026518
Policy instance 3
Insurance contract or identification numberR0026518
Number of Individuals Covered57
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,556
Total amount of fees paid to insurance companyUSD $90
Commission paid to Insurance BrokerUSD $2,556
Amount paid for insurance broker fees90
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524
Policy instance 4
Insurance contract or identification number152524
Number of Individuals Covered70
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,690
Total amount of fees paid to insurance companyUSD $431
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $21,839
Commission paid to Insurance BrokerUSD $3,690
Amount paid for insurance broker fees431
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 5
Insurance contract or identification number657869
Number of Individuals Covered188
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,089
Total amount of fees paid to insurance companyUSD $983
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,690
Commission paid to Insurance BrokerUSD $4,164
Amount paid for insurance broker fees866
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGOODWIN WRIGHT, INC.
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 6
Insurance contract or identification number10062
Number of Individuals Covered166
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $42,224
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $714,490
Commission paid to Insurance BrokerUSD $42,224
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 8
Insurance contract or identification number152523
Number of Individuals Covered188
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,013
Total amount of fees paid to insurance companyUSD $1,464
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $76,822
Commission paid to Insurance BrokerUSD $5,013
Amount paid for insurance broker fees1464
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9725821
Policy instance 1
Insurance contract or identification number9725821
Number of Individuals Covered143
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $897
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,537
Commission paid to Insurance BrokerUSD $897
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number729925
Policy instance 1
Insurance contract or identification number729925
Number of Individuals Covered161
Insurance policy start date2012-01-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $17,538
Total amount of fees paid to insurance companyUSD $1,733
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $350,752
Commission paid to Insurance BrokerUSD $17,538
Amount paid for insurance broker fees1733
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10062
Policy instance 4
Insurance contract or identification number10062
Number of Individuals Covered149
Insurance policy start date2012-08-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $11,893
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $312,834
Commission paid to Insurance BrokerUSD $11,893
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9725821
Policy instance 3
Insurance contract or identification number9725821
Number of Individuals Covered143
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $790
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,944
Commission paid to Insurance BrokerUSD $790
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05984593
Policy instance 5
Insurance contract or identification numberTM05984593
Number of Individuals Covered442
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,710
Total amount of fees paid to insurance companyUSD $4,533
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,693
Commission paid to Insurance BrokerUSD $3,710
Amount paid for insurance broker fees4533
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 6
Insurance contract or identification number657869
Number of Individuals Covered168
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,213
Total amount of fees paid to insurance companyUSD $1,006
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,852
Commission paid to Insurance BrokerUSD $4,265
Amount paid for insurance broker fees887
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameGOODWIN WRIGHT, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 2
Insurance contract or identification number152523
Number of Individuals Covered168
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,854
Total amount of fees paid to insurance companyUSD $1,156
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $72,883
Commission paid to Insurance BrokerUSD $4,854
Amount paid for insurance broker fees1156
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 3
Insurance contract or identification number152523
Number of Individuals Covered163
Insurance policy start date2011-08-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,188
Total amount of fees paid to insurance companyUSD $302
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,115
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number729925
Policy instance 1
Insurance contract or identification number729925
Number of Individuals Covered161
Insurance policy start date2011-08-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $14,451
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $289,026
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 2
Insurance contract or identification number657869
Number of Individuals Covered161
Insurance policy start date2011-08-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,828
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9725821
Policy instance 6
Insurance contract or identification number9725821
Number of Individuals Covered108
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $6,454
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,454
Commission paid to Insurance BrokerUSD $6,454
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152523
Policy instance 5
Insurance contract or identification number152523
Number of Individuals Covered142
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $3,706
Total amount of fees paid to insurance companyUSD $445
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,494
Commission paid to Insurance BrokerUSD $3,706
Amount paid for insurance broker fees445
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )
Policy contract number657869
Policy instance 4
Insurance contract or identification number657869
Number of Individuals Covered151
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $3,674
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,474
Commission paid to Insurance BrokerUSD $3,674
Insurance broker organization code?3
Insurance broker nameASBURY, DAVID H
COVENTRY HEALTH CARE OF GEORGIA (National Association of Insurance Commissioners NAIC id number: 95282 )
Policy contract number6509490000
Policy instance 3
Insurance contract or identification number6509490000
Number of Individuals Covered181
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $29,493
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $589,855
Commission paid to Insurance BrokerUSD $29,493
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number152524
Policy instance 2
Insurance contract or identification number152524
Number of Individuals Covered50
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $2,133
Total amount of fees paid to insurance companyUSD $142
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $14,222
Commission paid to Insurance BrokerUSD $2,133
Amount paid for insurance broker fees142
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number025462300
Policy instance 1
Insurance contract or identification number025462300
Number of Individuals Covered128
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $1,659
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,273
Commission paid to Insurance BrokerUSD $1,659
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA

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