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KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameKEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 502

KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

KEYSTONE INSURERS GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:KEYSTONE INSURERS GROUP, INC.
Employer identification number (EIN):232263940
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01JIM SPENCER2023-05-24
5022021-01-01JIM SPENCER2022-05-17
5022020-01-01JIM SPENCER2021-07-19
5022019-01-01JIM SPENCER2020-06-24
5022018-01-01JIM SPENCER2019-08-14
5022017-01-01

Plan Statistics for KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,572
Total number of active participants reported on line 7a of the Form 55002022-01-011,474
Total of all active and inactive participants2022-01-011,474
2021: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,650
Total number of active participants reported on line 7a of the Form 55002021-01-011,572
Total of all active and inactive participants2021-01-011,572
2020: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,685
Total number of active participants reported on line 7a of the Form 55002020-01-011,650
Total of all active and inactive participants2020-01-011,650
2019: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,775
Total number of active participants reported on line 7a of the Form 55002019-01-011,685
Total of all active and inactive participants2019-01-011,685
2018: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,730
Total number of active participants reported on line 7a of the Form 55002018-01-011,775
Total of all active and inactive participants2018-01-011,775
2017: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,738
Total number of active participants reported on line 7a of the Form 55002017-01-011,730
Total of all active and inactive participants2017-01-011,730
Total participants2017-01-011,730

Form 5500 Responses for KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN

2022: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: KEYSTONE INSURERS GROUP, INC. HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0176099
Policy instance 2
Insurance contract or identification number0176099
Number of Individuals Covered251
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $11,300
Total amount of fees paid to insurance companyUSD $5,000
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,967,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,300
Insurance broker organization code?3
Amount paid for insurance broker fees5000
Additional information about fees paid to insurance brokerBROKER BONUS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered1029
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $38,490
Total amount of fees paid to insurance companyUSD $15,097
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $524,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,490
Amount paid for insurance broker fees15097
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1474
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $148,474
Total amount of fees paid to insurance companyUSD $66,573
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $593,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148,474
Amount paid for insurance broker fees25000
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1326
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $76,516
Total amount of fees paid to insurance companyUSD $44,425
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $382,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76,516
Amount paid for insurance broker fees17644
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered615
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $31,001
Total amount of fees paid to insurance companyUSD $23,545
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,001
Amount paid for insurance broker fees9078
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1331
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $128,937
Total amount of fees paid to insurance companyUSD $78,091
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $758,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $128,937
Amount paid for insurance broker fees25000
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
EMPLOYEE NETWORK INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberKEY1790
Policy instance 7
Insurance contract or identification numberKEY1790
Number of Individuals Covered57
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0177964
Policy instance 8
Insurance contract or identification number0177964
Number of Individuals Covered336
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,290
Total amount of fees paid to insurance companyUSD $337
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,645
Amount paid for insurance broker fees337
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION, NON MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0177963
Policy instance 9
Insurance contract or identification number0177963
Number of Individuals Covered334
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,270
Total amount of fees paid to insurance companyUSD $605
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $64,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,135
Amount paid for insurance broker fees605
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION, NON MONETARY COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1572
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $141,268
Total amount of fees paid to insurance companyUSD $50,805
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $565,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $141,268
Amount paid for insurance broker fees11250
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number224377
Policy instance 2
Insurance contract or identification number224377
Number of Individuals Covered235
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $42,840
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,740,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,840
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered1158
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $48,965
Total amount of fees paid to insurance companyUSD $5,320
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $567,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,965
Amount paid for insurance broker fees5320
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0177964
Policy instance 8
Insurance contract or identification number0177964
Number of Individuals Covered249
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,115
Total amount of fees paid to insurance companyUSD $148
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,130
Insurance broker organization code?3
Amount paid for insurance broker fees148
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION, NON MONETARY COMPENSATION
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1301
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $70,578
Total amount of fees paid to insurance companyUSD $31,546
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $352,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,578
Amount paid for insurance broker fees6844
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered599
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $27,233
Total amount of fees paid to insurance companyUSD $16,599
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $181,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,233
Amount paid for insurance broker fees3890
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1429
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $121,654
Total amount of fees paid to insurance companyUSD $61,343
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $715,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $121,654
Amount paid for insurance broker fees11250
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
EMPLOYEE NETWORK INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberKEY1790
Policy instance 7
Insurance contract or identification numberKEY1790
Number of Individuals Covered57
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0177963
Policy instance 9
Insurance contract or identification number0177963
Number of Individuals Covered241
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,257
Total amount of fees paid to insurance companyUSD $297
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $45,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,098
Insurance broker organization code?3
Amount paid for insurance broker fees297
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION, NON MONETARY COMPENSATION
EMPLOYEE NETWORK INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberKEY1790
Policy instance 7
Insurance contract or identification numberKEY1790
Number of Individuals Covered57
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1485
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $115,179
Total amount of fees paid to insurance companyUSD $69,927
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $677,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $115,179
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered648
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $25,935
Total amount of fees paid to insurance companyUSD $20,538
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,935
Amount paid for insurance broker fees8435
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1274
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $60,835
Total amount of fees paid to insurance companyUSD $35,448
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $304,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,835
Amount paid for insurance broker fees14156
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1650
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $132,878
Total amount of fees paid to insurance companyUSD $59,706
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $531,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $132,878
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number224377
Policy instance 2
Insurance contract or identification number224377
Number of Individuals Covered267
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $41,112
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,688,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,112
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered1147
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $47,283
Total amount of fees paid to insurance companyUSD $5,339
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $528,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,283
Amount paid for insurance broker fees5339
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered1177
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $42,857
Total amount of fees paid to insurance companyUSD $121
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $533,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,857
Amount paid for insurance broker fees121
Additional information about fees paid to insurance brokerSUPPLEMENTAL/NON-MONETARY COMPENSATION
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number224377
Policy instance 2
Insurance contract or identification number224377
Number of Individuals Covered280
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $40,104
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,611,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,104
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1685
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $153,129
Total amount of fees paid to insurance companyUSD $61,324
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $612,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153,129
Amount paid for insurance broker fees18448
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1327
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $62,870
Total amount of fees paid to insurance companyUSD $35,600
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $314,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $62,870
Amount paid for insurance broker fees13595
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered641
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $28,117
Total amount of fees paid to insurance companyUSD $21,851
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,117
Amount paid for insurance broker fees8730
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1519
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $125,974
Total amount of fees paid to insurance companyUSD $70,320
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $741,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $125,974
Amount paid for insurance broker fees18448
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
EMPLOYEE NETWORK INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberKEY1790
Policy instance 7
Insurance contract or identification numberKEY1790
Number of Individuals Covered57
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered1208
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $52,807
Total amount of fees paid to insurance companyUSD $6,640
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $491,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,807
Amount paid for insurance broker fees6640
Additional information about fees paid to insurance brokerSUPPLEMENTAL/NON-MONETARY COMPENSATION
Insurance broker organization code?3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number224377
Policy instance 2
Insurance contract or identification number224377
Number of Individuals Covered281
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $36,504
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,381,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,504
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1775
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $186,445
Total amount of fees paid to insurance companyUSD $67,423
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $745,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $186,445
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1347
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $73,694
Total amount of fees paid to insurance companyUSD $34,965
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $368,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,694
Amount paid for insurance broker fees12715
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered705
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $35,490
Total amount of fees paid to insurance companyUSD $22,038
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $236,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,490
Amount paid for insurance broker fees7741
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1624
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $157,610
Total amount of fees paid to insurance companyUSD $78,165
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $927,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $157,610
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
EMPLOYEE NETWORK INC. (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberKEY1790
Policy instance 7
Insurance contract or identification numberKEY1790
Number of Individuals Covered57
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124537
Policy instance 6
Insurance contract or identification number10124537
Number of Individuals Covered1656
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $124,498
Total amount of fees paid to insurance companyUSD $22,500
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $732,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $124,498
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURERS GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124538
Policy instance 5
Insurance contract or identification number10124538
Number of Individuals Covered689
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,802
Total amount of fees paid to insurance companyUSD $7,904
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,802
Amount paid for insurance broker fees7904
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURERS GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 11209
Policy instance 4
Insurance contract or identification number400001000 11209
Number of Individuals Covered1362
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $56,510
Total amount of fees paid to insurance companyUSD $13,407
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $282,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,510
Amount paid for insurance broker fees13407
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURERS GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10124536
Policy instance 3
Insurance contract or identification number10124536
Number of Individuals Covered1730
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $138,221
Total amount of fees paid to insurance companyUSD $22,500
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $552,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $138,221
Amount paid for insurance broker fees22500
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURERS GROUP, INC.
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number698317
Policy instance 2
Insurance contract or identification number698317
Number of Individuals Covered70
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,453
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,453
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURANCE & BENEFITS GROUP
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number167942
Policy instance 1
Insurance contract or identification number167942
Number of Individuals Covered209
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,609
Total amount of fees paid to insurance companyUSD $414
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,366
Amount paid for insurance broker fees155
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameKEYSTONE INSURERS GROUP, INC.

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