UNION ASSOCIATED PHYSICIANS CLINIC, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UNION ASSOCIATED PHYSICIANS CLINIC LLC HEALTH BENEFIT PLAN
401k plan membership statisitcs for UNION ASSOCIATED PHYSICIANS CLINIC LLC HEALTH BENEFIT PLAN
AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | AF15-0167-22 |
Policy instance | 6 |
Insurance contract or identification number | AF15-0167-22 | Number of Individuals Covered | 302 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $51,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-020123-00 |
Policy instance | 5 |
Insurance contract or identification number | 01-020123-00 | Number of Individuals Covered | 102 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $4,132 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LIFE, AD&D, ST DISAB, LT DISAB | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $26,885 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 319 | Additional information about fees paid to insurance broker | ADMINISTRATION FEE | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-020123-00 |
Policy instance | 4 |
Insurance contract or identification number | 01-020123-00 | Number of Individuals Covered | 51 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $7,274 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ST DISAB | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $47,293 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1307 | Additional information about fees paid to insurance broker | ADMINISTRATION FEE | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-020123-00 |
Policy instance | 3 |
Insurance contract or identification number | 01-020123-00 | Number of Individuals Covered | 102 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $4,537 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $35,924 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 426 | Additional information about fees paid to insurance broker | ADMINISTRATION FEE | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0119263 |
Policy instance | 2 |
Insurance contract or identification number | R0119263 | Number of Individuals Covered | 92 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-03-31 | Total amount of commissions paid to insurance broker | USD $1,206 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GCIEE, GRPACCVO | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $16,151 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $895 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008460659 |
Policy instance | 1 |
Insurance contract or identification number | 0008460659 | Number of Individuals Covered | 25 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-03-31 | Total amount of commissions paid to insurance broker | USD $243 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCDNT, CRIT ILLN, ISWL, WHOLE LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,806 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $155 | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-020123-00 |
Policy instance | 1 |
Insurance contract or identification number | 01-020123-00 | Number of Individuals Covered | 1107 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $20,544 | Other welfare benefits provided | LIFE, AD&D, ST DISAB, LT DISAB | Welfare Benefit Premiums Paid to Carrier | USD $283,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 9825 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008460659 |
Policy instance | 2 |
Insurance contract or identification number | 0008460659 | Number of Individuals Covered | 132 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $1,507 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCDNT, CRIT ILLN, ISWL, WHOLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $31,767 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $548 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0119263 |
Policy instance | 3 |
Insurance contract or identification number | R0119263 | Number of Individuals Covered | 106 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $2,396 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GCIEE, GRPACCVO | Welfare Benefit Premiums Paid to Carrier | USD $32,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,917 | Insurance broker organization code? | 3 |
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AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) |
Policy contract number | AF15-0166-21 |
Policy instance | 4 |
Insurance contract or identification number | AF15-0166-21 | Number of Individuals Covered | 979 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 $190,704 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008460659 |
Policy instance | 5 |
Insurance contract or identification number | 0008460659 | Number of Individuals Covered | 150 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $1,708 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCDNT, CRIT ILLN, ISWL, WHOLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $36,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $635 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0119263 |
Policy instance | 4 |
Insurance contract or identification number | R0119263 | Number of Individuals Covered | 114 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $2,720 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GCIEE, GRPACCVO | Welfare Benefit Premiums Paid to Carrier | USD $36,447 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,712 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 3 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 392 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,283 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability 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 $1,283 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 2 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 750 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $2,206 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability 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 $2,206 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 1 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 750 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,831 | Total amount of fees paid to insurance company | USD $0 | Life 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 $1,831 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122799 0800 |
Policy instance | 8 |
Insurance contract or identification number | 122799 0800 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $236 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $1,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $236 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 1 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 718 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,632 | Life 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 $1,632 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008460659 |
Policy instance | 2 |
Insurance contract or identification number | 0008460659 | Number of Individuals Covered | 163 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $1,858 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS, WHOLE LIFE, ISWL | Welfare Benefit Premiums Paid to Carrier | USD $39,677 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $685 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0119263 |
Policy instance | 3 |
Insurance contract or identification number | R0119263 | Number of Individuals Covered | 139 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $3,234 | Other welfare benefits provided | GCIEE, GRPACCVO | Welfare Benefit Premiums Paid to Carrier | USD $43,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,587 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 4 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 316 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,918 | Long Term Disability 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 $1,918 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 5 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 344 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $890 | Temporary Disability 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 $890 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122799 0001 |
Policy instance | 6 |
Insurance contract or identification number | 122799 0001 | Number of Individuals Covered | 83 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $2,026 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $14,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,026 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122799 0002 |
Policy instance | 7 |
Insurance contract or identification number | 122799 0002 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $138 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $138 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0008460659 |
Policy instance | 2 |
Insurance contract or identification number | 0008460659 | Number of Individuals Covered | 244 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $2,676 | Total amount of fees paid to insurance company | USD $302 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS, WHOLE LIFE, ISWL | Welfare Benefit Premiums Paid to Carrier | USD $57,395 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,051 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 302 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0119263 |
Policy instance | 3 |
Insurance contract or identification number | R0119263 | Number of Individuals Covered | 154 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $4,406 | Other welfare benefits provided | GCIEE, GRPACCVO | Welfare Benefit Premiums Paid to Carrier | USD $58,104 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,525 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 4 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 322 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,495 | Long Term Disability 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 $2,495 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 5 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 301 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,072 | Temporary Disability 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 $1,072 | Insurance broker organization code? | 3 |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | LGS01188-18 |
Policy instance | 6 |
Insurance contract or identification number | LGS01188-18 | Number of Individuals Covered | 464 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $8,313 | Welfare Benefit Premiums Paid to Carrier | USD $207,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,313 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122799 |
Policy instance | 7 |
Insurance contract or identification number | 122799 | Number of Individuals Covered | 81 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $2,139 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $16,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,139 | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 753409 |
Policy instance | 1 |
Insurance contract or identification number | 753409 | Number of Individuals Covered | 705 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,802 | Life 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 $1,802 | Insurance broker organization code? | 3 |
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