SERVICE ACCESS & MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN
401k plan membership statisitcs for SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN
Measure | Date | Value |
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2020: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 574 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 588 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 9 |
Total of all active and inactive participants | 2020-07-01 | 597 |
2019: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 546 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 574 |
Total of all active and inactive participants | 2019-07-01 | 574 |
2018: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 576 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 545 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 546 |
2017: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 567 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 573 |
Number of retired or separated participants receiving benefits | 2017-07-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
Total of all active and inactive participants | 2017-07-01 | 576 |
2016: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 650 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 552 |
Number of retired or separated participants receiving benefits | 2016-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 13 |
Total of all active and inactive participants | 2016-07-01 | 567 |
2015: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 635 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 627 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 20 |
Total of all active and inactive participants | 2015-07-01 | 650 |
2014: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 636 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 611 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 22 |
Total of all active and inactive participants | 2014-07-01 | 635 |
2013: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 618 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 594 |
Number of retired or separated participants receiving benefits | 2013-07-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 36 |
Total of all active and inactive participants | 2013-07-01 | 636 |
2012: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 574 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 613 |
Number of retired or separated participants receiving benefits | 2012-07-01 | 5 |
Total of all active and inactive participants | 2012-07-01 | 618 |
2011: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 536 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 569 |
Number of retired or separated participants receiving benefits | 2011-07-01 | 5 |
Total of all active and inactive participants | 2011-07-01 | 574 |
2010: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-07-01 | 498 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 530 |
Number of retired or separated participants receiving benefits | 2010-07-01 | 6 |
Total of all active and inactive participants | 2010-07-01 | 536 |
2009: SERVICE ACCESS MANAGEMENT INC. WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 440 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 445 |
Number of retired or separated participants receiving benefits | 2009-07-01 | 6 |
Total of all active and inactive participants | 2009-07-01 | 451 |
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967841 |
Policy instance | 4 |
Insurance contract or identification number | FLX967841 | Number of Individuals Covered | 543 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $20,007 | Total amount of fees paid to insurance company | USD $2,261 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $118,435 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,007 | Amount paid for insurance broker fees | 2261 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | CI960424 |
Policy instance | 2 |
Insurance contract or identification number | CI960424 | Number of Individuals Covered | 311 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $3,906 | Total amount of fees paid to insurance company | USD $799 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $33,343 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,906 | Amount paid for insurance broker fees | 799 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | AI960420 |
Policy instance | 1 |
Insurance contract or identification number | AI960420 | Number of Individuals Covered | 233 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $5,102 | Total amount of fees paid to insurance company | USD $1,044 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,168 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,000 | Amount paid for insurance broker fees | 824 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967840 |
Policy instance | 3 |
Insurance contract or identification number | FLX967840 | Number of Individuals Covered | 799 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $3,127 | Total amount of fees paid to insurance company | USD $625 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,935 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,127 | Amount paid for insurance broker fees | 625 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK969339 |
Policy instance | 5 |
Insurance contract or identification number | OK969339 | Number of Individuals Covered | 543 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $2,559 | Total amount of fees paid to insurance company | USD $512 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $23,929 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,559 | Amount paid for insurance broker fees | 512 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962333 |
Policy instance | 6 |
Insurance contract or identification number | VDT962333 | Number of Individuals Covered | 467 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $13,554 | Total amount of fees paid to insurance company | USD $1,807 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,097 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,554 | Amount paid for insurance broker fees | 1807 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962332 |
Policy instance | 7 |
Insurance contract or identification number | VDT962332 | Number of Individuals Covered | 357 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,890 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $99,216 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1890 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | HC960783 |
Policy instance | 8 |
Insurance contract or identification number | HC960783 | Number of Individuals Covered | 143 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $20,663 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,438 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,663 | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | CI960424 |
Policy instance | 2 |
Insurance contract or identification number | CI960424 | Number of Individuals Covered | 235 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $1,748 | Total amount of fees paid to insurance company | USD $437 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $28,441 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,748 | Amount paid for insurance broker fees | 437 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967841 |
Policy instance | 4 |
Insurance contract or identification number | FLX967841 | Number of Individuals Covered | 547 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $15,667 | Total amount of fees paid to insurance company | USD $1,770 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $95,989 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,667 | Amount paid for insurance broker fees | 1770 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK969339 |
Policy instance | 5 |
Insurance contract or identification number | OK969339 | Number of Individuals Covered | 806 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $1,967 | Total amount of fees paid to insurance company | USD $393 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,967 | Amount paid for insurance broker fees | 393 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967840 |
Policy instance | 3 |
Insurance contract or identification number | FLX967840 | Number of Individuals Covered | 806 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $2,295 | Total amount of fees paid to insurance company | USD $459 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,886 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,295 | Amount paid for insurance broker fees | 459 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962333 |
Policy instance | 6 |
Insurance contract or identification number | VDT962333 | Number of Individuals Covered | 464 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $9,349 | Total amount of fees paid to insurance company | USD $1,246 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $67,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,349 | Amount paid for insurance broker fees | 1246 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | AI960420 |
Policy instance | 1 |
Insurance contract or identification number | AI960420 | Number of Individuals Covered | 213 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $2,404 | Total amount of fees paid to insurance company | USD $601 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,107 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,404 | Amount paid for insurance broker fees | 601 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962332 |
Policy instance | 7 |
Insurance contract or identification number | VDT962332 | Number of Individuals Covered | 327 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,442 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $78,214 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1442 | Additional information about fees paid to insurance broker | SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962332 |
Policy instance | 7 |
Insurance contract or identification number | VDT962332 | Number of Individuals Covered | 305 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,484 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $74,220 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1484 | Additional information about fees paid to insurance broker | SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962333 |
Policy instance | 6 |
Insurance contract or identification number | VDT962333 | Number of Individuals Covered | 407 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $9,610 | Total amount of fees paid to insurance company | USD $1,281 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,610 | Amount paid for insurance broker fees | 1281 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK969339 |
Policy instance | 5 |
Insurance contract or identification number | OK969339 | Number of Individuals Covered | 476 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $2,172 | Total amount of fees paid to insurance company | USD $435 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $20,231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,172 | Amount paid for insurance broker fees | 435 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967841 |
Policy instance | 4 |
Insurance contract or identification number | FLX967841 | Number of Individuals Covered | 476 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $16,114 | Total amount of fees paid to insurance company | USD $1,821 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $91,038 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,114 | Amount paid for insurance broker fees | 1821 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967840 |
Policy instance | 3 |
Insurance contract or identification number | FLX967840 | Number of Individuals Covered | 754 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $2,360 | Total amount of fees paid to insurance company | USD $472 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,602 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,360 | Amount paid for insurance broker fees | 472 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | CI960424 |
Policy instance | 2 |
Insurance contract or identification number | CI960424 | Number of Individuals Covered | 176 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $3,190 | Total amount of fees paid to insurance company | USD $540 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $26,974 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,190 | Amount paid for insurance broker fees | 540 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | AI960420 |
Policy instance | 1 |
Insurance contract or identification number | AI960420 | Number of Individuals Covered | 233 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $4,386 | Total amount of fees paid to insurance company | USD $742 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,386 | Amount paid for insurance broker fees | 742 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4065410010 |
Policy instance | 1 |
Insurance contract or identification number | 4065410010 | Number of Individuals Covered | 517 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $326,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT962333 |
Policy instance | 7 |
Insurance contract or identification number | VDT962333 | Number of Individuals Covered | 411 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $10,999 | Total amount of fees paid to insurance company | USD $1,466 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65,742 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,999 | Amount paid for insurance broker fees | 1466 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | CI960424 |
Policy instance | 3 |
Insurance contract or identification number | CI960424 | Number of Individuals Covered | 246 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $14,720 | Total amount of fees paid to insurance company | USD $491 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $24,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,720 | Amount paid for insurance broker fees | 491 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967841 |
Policy instance | 5 |
Insurance contract or identification number | FLX967841 | Number of Individuals Covered | 483 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $18,290 | Total amount of fees paid to insurance company | USD $2,067 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $92,993 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,290 | Amount paid for insurance broker fees | 2067 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK969339 |
Policy instance | 6 |
Insurance contract or identification number | OK969339 | Number of Individuals Covered | 751 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $4,364 | Total amount of fees paid to insurance company | USD $873 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $21,798 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,364 | Amount paid for insurance broker fees | 873 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | AI960420 |
Policy instance | 2 |
Insurance contract or identification number | AI960420 | Number of Individuals Covered | 242 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $20,240 | Total amount of fees paid to insurance company | USD $674 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,733 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,240 | Amount paid for insurance broker fees | 674 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX967840 |
Policy instance | 4 |
Insurance contract or identification number | FLX967840 | Number of Individuals Covered | 751 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $2,831 | Total amount of fees paid to insurance company | USD $566 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,831 | Amount paid for insurance broker fees | 566 | Additional information about fees paid to insurance broker | COMMISSIONS & SERVICE FEES | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) |
Policy contract number | D3415N |
Policy instance | 5 |
Insurance contract or identification number | D3415N | Number of Individuals Covered | 1189 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $51,554 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $254,349 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,554 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 4 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 181 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 3 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 653 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $1,664 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,664 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 521 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 340 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $146,699 | Total amount of fees paid to insurance company | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $146,699 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0009100995 |
Policy instance | 6 |
Insurance contract or identification number | 0009100995 | Number of Individuals Covered | 32 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,916 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,322 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,916 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 306 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $141,572 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $141,572 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 3 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 576 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,508 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,508 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0351130 |
Policy instance | 4 |
Insurance contract or identification number | R0351130 | Number of Individuals Covered | 764 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $22,635 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $177,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,635 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0351270 |
Policy instance | 7 |
Insurance contract or identification number | R0351270 | Number of Individuals Covered | 122 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,348 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,237 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,348 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 5 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 181 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 487 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 3 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 559 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $1,518 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,518 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 5 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 214 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0351130 |
Policy instance | 4 |
Insurance contract or identification number | R0351130 | Number of Individuals Covered | 750 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $21,366 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $151,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,366 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST INC |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 490 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 276 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $152,983 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $152,983 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 303 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $152,773 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $152,773 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 5 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 207 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0351130 |
Policy instance | 4 |
Insurance contract or identification number | R0351130 | Number of Individuals Covered | 785 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $23,482 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $167,263 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,482 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 3 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 581 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $1,442 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,442 | Insurance broker organization code? | 3 | Insurance broker name | EMPLOYEE BENEFIT SPECIALIST |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 510 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 278 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $94,450 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 462 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KEYSTONE HEALTH PLAN CENTRAL (National Association of Insurance Commissioners NAIC id number: 95199 ) |
Policy contract number | 00500076 |
Policy instance | 3 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 184 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $43,638 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 5 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 520 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $1,121 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0351130 |
Policy instance | 6 |
Insurance contract or identification number | R0351130 | Number of Individuals Covered | 689 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $14,124 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $98,831 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 04558 |
Policy instance | 4 |
Insurance contract or identification number | 04558 | Number of Individuals Covered | 1124 | Insurance policy start date | 2011-07-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $5,832 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $174,813 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 1 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 252 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $85,437 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CAPITAL ADVANTAGE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 41203 ) |
Policy contract number | 00500076 |
Policy instance | 2 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 411 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 140782 |
Policy instance | 4 |
Insurance contract or identification number | GL 140782 | Number of Individuals Covered | 473 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $1,919 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | A D&D | Welfare Benefit Premiums Paid to Carrier | USD $23,370 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | PA04558 |
Policy instance | 5 |
Insurance contract or identification number | PA04558 | Number of Individuals Covered | 959 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $5,227 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $172,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 ) |
Policy contract number | 3043 |
Policy instance | 6 |
Insurance contract or identification number | 3043 | Number of Individuals Covered | 452 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $993 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KEYSTONE HEALTH PLAN CENTRAL (National Association of Insurance Commissioners NAIC id number: 95199 ) |
Policy contract number | 00500076 |
Policy instance | 3 |
Insurance contract or identification number | 00500076 | Number of Individuals Covered | 159 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $34,652 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|