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MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number 501

MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • 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

MASTER WOODCRAFT CABINETRY, LLC has sponsored the creation of one or more 401k plans.

Company Name:MASTER WOODCRAFT CABINETRY, LLC
Employer identification number (EIN):203769491
NAIC Classification:321900

Additional information about MASTER WOODCRAFT CABINETRY, LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 1345769

More information about MASTER WOODCRAFT CABINETRY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-06-01MARK TREXLER2020-03-05 MARK TREXLER2020-03-05
5012018-06-01
5012017-06-01
5012016-06-01
5012015-06-01
5012014-06-01
5012013-06-01
5012012-06-01ANITA WINDHAM
5012011-06-01ANITA WINDHAM

Plan Statistics for MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2018: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-06-01422
Total number of active participants reported on line 7a of the Form 55002018-06-01413
Total of all active and inactive participants2018-06-01413
Total participants2018-06-01413
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
2017: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01380
Total number of active participants reported on line 7a of the Form 55002017-06-01422
Total of all active and inactive participants2017-06-01422
Total participants2017-06-01422
2016: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01366
Total number of active participants reported on line 7a of the Form 55002016-06-01380
Total of all active and inactive participants2016-06-01380
Total participants2016-06-01380
2015: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01393
Total number of active participants reported on line 7a of the Form 55002015-06-01366
Total of all active and inactive participants2015-06-01366
Total participants2015-06-01366
2014: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01290
Total number of active participants reported on line 7a of the Form 55002014-06-01393
Total of all active and inactive participants2014-06-01393
Total participants2014-06-01393
2013: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01176
Total number of active participants reported on line 7a of the Form 55002013-06-01290
Total of all active and inactive participants2013-06-01290
Total participants2013-06-01290
2012: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01161
Total number of active participants reported on line 7a of the Form 55002012-06-01176
Total of all active and inactive participants2012-06-01176
Total participants2012-06-01176
2011: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-01141
Total number of active participants reported on line 7a of the Form 55002011-06-01161
Total of all active and inactive participants2011-06-01161
Total participants2011-06-01161

Form 5500 Responses for MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN

2018: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Submission has been amendedYes
2018-06-01This submission is the final filingYes
2018-06-01This return/report is a short plan year return/report (less than 12 months)No
2018-06-01Plan is a collectively bargained planNo
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: MASTER WOODCRAFT CABINETRY, LLC EMPLOYEE WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398713
Policy instance 5
Insurance contract or identification number398713
Number of Individuals Covered0
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $9,457
Total amount of fees paid to insurance companyUSD $473
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,457
Amount paid for insurance broker fees473
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0494088
Policy instance 4
Insurance contract or identification numberR0494088
Number of Individuals Covered378
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $7,696
Total amount of fees paid to insurance companyUSD $250
Other welfare benefits providedACCIDENTAL AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $93,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,696
Amount paid for insurance broker fees250
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398714
Policy instance 3
Insurance contract or identification number398714
Number of Individuals Covered231
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $10,090
Total amount of fees paid to insurance companyUSD $504
Other welfare benefits providedLIFESTYLE ACCIDENTAL DEATH DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $67,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,090
Amount paid for insurance broker fees504
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398713
Policy instance 2
Insurance contract or identification number398713
Number of Individuals Covered209
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $9,457
Total amount of fees paid to insurance companyUSD $473
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,457
Amount paid for insurance broker fees473
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398712
Policy instance 1
Insurance contract or identification number398712
Number of Individuals Covered449
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $19,587
Total amount of fees paid to insurance companyUSD $979
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT ADD
Welfare Benefit Premiums Paid to CarrierUSD $130,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,587
Amount paid for insurance broker fees979
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number694746
Policy instance 6
Insurance contract or identification number694746
Number of Individuals Covered413
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $18,382
Total amount of fees paid to insurance companyUSD $27,616
Other welfare benefits providedAGGREGATE AND INDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $552,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,382
Amount paid for insurance broker fees27616
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number694746
Policy instance 1
Insurance contract or identification number694746
Number of Individuals Covered0
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $18,382
Total amount of fees paid to insurance companyUSD $27,616
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAGGREGATE AND INDIVIDUAL EXCESS RISK
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $552,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,382
Amount paid for insurance broker fees27616
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001311
Policy instance 5
Insurance contract or identification number1001311
Number of Individuals Covered558
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Welfare Benefit Premiums Paid to CarrierUSD $29,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001311
Policy instance 2
Insurance contract or identification number1001311
Number of Individuals Covered0
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $29,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398713
Policy instance 2
Insurance contract or identification number398713
Number of Individuals Covered221
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $7,973
Total amount of fees paid to insurance companyUSD $399
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RXBENEFITS (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberN/A
Policy instance 7
Insurance contract or identification numberN/A
Number of Individuals Covered419
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of fees paid to insurance companyUSD $2,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number694746
Policy instance 6
Insurance contract or identification number694746
Number of Individuals Covered532
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $16,002
Total amount of fees paid to insurance companyUSD $23,613
Other welfare benefits providedAGGREGATE AND INDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $472,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0494088
Policy instance 4
Insurance contract or identification numberR0494088
Number of Individuals Covered365
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $5,734
Total amount of fees paid to insurance companyUSD $193
Other welfare benefits providedACCIDENTAL AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $65,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number9473763
Policy instance 5
Insurance contract or identification number9473763
Number of Individuals Covered394
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Welfare Benefit Premiums Paid to CarrierUSD $44,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398714
Policy instance 3
Insurance contract or identification number398714
Number of Individuals Covered249
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $8,092
Total amount of fees paid to insurance companyUSD $405
Other welfare benefits providedLIFESTYLE ACCIDENTAL DEATH DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $53,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398712
Policy instance 1
Insurance contract or identification number398712
Number of Individuals Covered440
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $18,405
Total amount of fees paid to insurance companyUSD $920
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT ADD
Welfare Benefit Premiums Paid to CarrierUSD $122,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number9471262
Policy instance 6
Insurance contract or identification number9471262
Number of Individuals Covered366
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $304,190
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $41,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $135,630
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?5
Insurance broker nameAMERICAN HEALTH HOLDIN
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number240818
Policy instance 2
Insurance contract or identification number240818
Number of Individuals Covered366
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $5,587
Other welfare benefits providedSTOP LOSS AGGREGATE STOP LOSS SPECIFIC
Welfare Benefit Premiums Paid to CarrierUSD $519,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,587
Insurance broker organization code?3
Insurance broker nameSTEPHENS INSURANCE LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398712
Policy instance 1
Insurance contract or identification number398712
Number of Individuals Covered371
Insurance policy start date2015-07-01
Insurance policy end date2016-07-01
Total amount of commissions paid to insurance brokerUSD $14,988
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT ADD
Welfare Benefit Premiums Paid to CarrierUSD $96,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,988
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0494088
Policy instance 5
Insurance contract or identification numberR0494088
Number of Individuals Covered209
Insurance policy start date2015-05-31
Insurance policy end date2016-05-30
Total amount of commissions paid to insurance brokerUSD $7,543
Other welfare benefits providedVOLUNTARY LIFE INSURANCE GCIEE
Welfare Benefit Premiums Paid to CarrierUSD $72,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,543
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398714
Policy instance 4
Insurance contract or identification number398714
Number of Individuals Covered236
Insurance policy start date2015-07-01
Insurance policy end date2016-07-01
Total amount of commissions paid to insurance brokerUSD $5,983
Other welfare benefits providedLIFESTYLE ACCIDENTAL DEATH DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $38,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,983
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398713
Policy instance 3
Insurance contract or identification number398713
Number of Individuals Covered245
Insurance policy start date2015-07-01
Insurance policy end date2016-07-01
Total amount of commissions paid to insurance brokerUSD $8,816
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,816
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398712
Policy instance 1
Insurance contract or identification number398712
Number of Individuals Covered393
Insurance policy start date2014-07-01
Insurance policy end date2015-07-01
Total amount of commissions paid to insurance brokerUSD $13,979
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT ADD
Welfare Benefit Premiums Paid to CarrierUSD $93,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,979
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number405209
Policy instance 2
Insurance contract or identification number405209
Number of Individuals Covered363
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of fees paid to insurance companyUSD $274,595
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEATH BENEFITS OTHER THAN LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $420,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees122820
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?5
Insurance broker nameAMERICAN HEALTH HOLDING
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398714
Policy instance 4
Insurance contract or identification number398714
Number of Individuals Covered244
Insurance policy start date2014-07-01
Insurance policy end date2015-07-01
Total amount of commissions paid to insurance brokerUSD $3,858
Other welfare benefits providedLIFESTYLE ACCIDENTAL DEATH DISABILITY LIFESTYLE LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $25,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,858
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398713
Policy instance 3
Insurance contract or identification number398713
Number of Individuals Covered280
Insurance policy start date2014-07-01
Insurance policy end date2015-07-01
Total amount of commissions paid to insurance brokerUSD $6,375
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,375
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0494088
Policy instance 5
Insurance contract or identification numberR0494088
Number of Individuals Covered308
Insurance policy start date2014-07-01
Insurance policy end date2015-07-01
Total amount of commissions paid to insurance brokerUSD $11,890
Other welfare benefits providedVOLUNTARY LIFE INSURANCE GCIEE VOLUNTARY ACCIDENTAL INSURANCE GRPACCVO
Welfare Benefit Premiums Paid to CarrierUSD $64,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,890
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001124-05
Policy instance 2
Insurance contract or identification number001124-05
Number of Individuals Covered321
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $-183
Total amount of fees paid to insurance companyUSD $192,906
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEATH BENEFITS OTHER THAN LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $471,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-183
Amount paid for insurance broker fees87150
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?5
Insurance broker nameAMERICAN HEALTH HOLDING
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number398712
Policy instance 1
Insurance contract or identification number398712
Number of Individuals Covered290
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $7,776
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,776
Insurance broker organization code?3
Insurance broker nameSNELLINGS WALTERS INSURANCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADD2
Policy instance 1
Insurance contract or identification numberG000ADD2
Number of Individuals Covered176
Insurance policy start date2012-06-01
Insurance policy end date2013-06-01
Total amount of commissions paid to insurance brokerUSD $2,975
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,975
Insurance broker organization code?3
Insurance broker name
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001124-05
Policy instance 2
Insurance contract or identification number001124-05
Number of Individuals Covered218
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $71,904
Total amount of fees paid to insurance companyUSD $84,314
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEATH BENEFITS OTHER THAN LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $483,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,904
Amount paid for insurance broker fees10540
Additional information about fees paid to insurance brokerBROKER FEES
Insurance broker organization code?5
Insurance broker nameAMERICAN HEALTH HOLDING
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADD2
Policy instance 1
Insurance contract or identification numberG000ADD2
Number of Individuals Covered161
Insurance policy start date2011-06-01
Insurance policy end date2012-06-01
Total amount of commissions paid to insurance brokerUSD $2,665
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35408 )
Policy contract number001124-03
Policy instance 2
Insurance contract or identification number001124-03
Number of Individuals Covered205
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $54,601
Total amount of fees paid to insurance companyUSD $75,757
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedDEATH BENEFITS OTHER THAN LIFE INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $367,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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