SECURITY 1ST TITLE, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 507 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 517 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 519 |
2021: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 396 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 508 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 511 |
2020: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 346 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 396 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 398 |
2019: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 321 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 346 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 350 |
2018: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 297 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 321 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 321 |
2017: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 247 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 297 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 300 |
2016: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 245 |
Total of all active and inactive participants | 2016-01-01 | 245 |
2015: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 181 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 193 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 193 |
2014: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 182 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 181 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 181 |
2013: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 173 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 182 |
Total of all active and inactive participants | 2013-01-01 | 182 |
2012: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 173 |
Total of all active and inactive participants | 2012-01-01 | 173 |
2011: SECURITY 1ST TITLE, LLC WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 122 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 127 |
Total of all active and inactive participants | 2011-01-01 | 127 |
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 8 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 399 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $23,031 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | 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 $285,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,031 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 518 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,594 | Total amount of fees paid to insurance company | USD $8,947 | 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 | Yes | 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 $134,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6325 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,594 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 518 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,632 | Total amount of fees paid to insurance company | USD $9,221 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | 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 $138,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6539 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,632 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 518 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,078 | Total amount of fees paid to insurance company | USD $7,740 | 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 $107,756 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,078 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5058 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 222 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $9,538 | Total amount of fees paid to insurance company | USD $8,307 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D-VOLUNTARY | 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 $105,959 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,538 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5619 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 5 |
Insurance contract or identification number | 0000019776 | Number of Individuals Covered | 207 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $18,072 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | ACCIDENT, CRITICAL ILLNESS | 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 $99,321 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,910 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 23 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $363 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | 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 $3,634 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $363 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 7 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 363 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6,575 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | 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 $65,754 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,575 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 512 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,368 | Total amount of fees paid to insurance company | USD $7,568 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,774 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5648 | Additional information about fees paid to insurance broker | ADMIN FEES | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,368 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 512 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,410 | Total amount of fees paid to insurance company | USD $7,793 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $115,970 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5873 | Additional information about fees paid to insurance broker | ADMIN FEES | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,410 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 512 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,895 | Total amount of fees paid to insurance company | USD $6,455 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $89,534 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,895 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4535 | Additional information about fees paid to insurance broker | ADMIN FEES |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 209 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $9,254 | Total amount of fees paid to insurance company | USD $6,780 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D-VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $99,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,254 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4860 | Additional information about fees paid to insurance broker | ADMIN FEES |
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DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674 |
Policy instance | 5 |
Insurance contract or identification number | 51674 | Number of Individuals Covered | 379 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $19,430 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $241,141 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,430 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 343 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,556 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,564 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,556 | Insurance broker organization code? | 3 |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 7 |
Insurance contract or identification number | 0000019776 | Number of Individuals Covered | 250 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $16,454 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $93,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,649 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 8 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 23 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $275 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,749 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $275 | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 71387-2 |
Policy instance | 9 |
Insurance contract or identification number | 71387-2 | Number of Individuals Covered | 345 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $17,237 | Total amount of fees paid to insurance company | USD $15,571 | Welfare Benefit Premiums Paid to Carrier | USD $544,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,237 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 15571 | Additional information about fees paid to insurance broker | SERVICE FEE |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 417003413867 |
Policy instance | 10 |
Insurance contract or identification number | 417003413867 | Number of Individuals Covered | 341 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $102,383 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $645,634 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $102,383 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 60498 |
Policy instance | 11 |
Insurance contract or identification number | 60498 | Number of Individuals Covered | 128 | 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 | Other welfare benefits provided | FSA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 60498 |
Policy instance | 12 |
Insurance contract or identification number | 60498 | Number of Individuals Covered | 187 | 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 | Other welfare benefits provided | HSA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 405 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $5,032 | Total amount of fees paid to insurance company | USD $7,120 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $91,272 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5200 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $5,032 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 405 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,702 | Total amount of fees paid to insurance company | USD $5,880 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,171 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,702 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3960 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 165 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $7,940 | Total amount of fees paid to insurance company | USD $6,598 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D-VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $77,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,940 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4678 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674 |
Policy instance | 5 |
Insurance contract or identification number | 51674 | Number of Individuals Covered | 302 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $16,855 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $201,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,855 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 274 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,722 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $47,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,722 | Insurance broker organization code? | 3 |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 7 |
Insurance contract or identification number | 0000019776 | Number of Individuals Covered | 241 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $13,091 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $79,395 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,815 | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 417003413867 |
Policy instance | 9 |
Insurance contract or identification number | 417003413867 | Number of Individuals Covered | 270 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $92,926 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $498,868 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $92,926 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 405 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,931 | Total amount of fees paid to insurance company | USD $6,814 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,931 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4894 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 8 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 20 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $321 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,208 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $321 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 234 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,107 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,068 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,107 | Insurance broker organization code? | 3 |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 8 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 23 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $320 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,204 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $320 | Insurance broker organization code? | 3 |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 7 |
Insurance contract or identification number | 0000019776 | Number of Individuals Covered | 217 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $10,991 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $78,815 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,125 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674 |
Policy instance | 5 |
Insurance contract or identification number | 51674 | Number of Individuals Covered | 260 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $14,734 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $184,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,734 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 148 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $7,500 | Total amount of fees paid to insurance company | USD $2,730 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D-VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $70,002 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,500 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2730 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 348 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,594 | Total amount of fees paid to insurance company | USD $2,363 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,360 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,594 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2363 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 348 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,701 | Total amount of fees paid to insurance company | USD $3,107 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $78,040 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,701 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3107 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 347 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,584 | Total amount of fees paid to insurance company | USD $2,928 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,379 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,584 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2928 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | 417002413867 |
Policy instance | 9 |
Insurance contract or identification number | 417002413867 | Number of Individuals Covered | 233 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $75,518 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $411,562 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $75,518 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 10 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 0 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $336 | Total amount of fees paid to insurance company | USD $155 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,942 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $336 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 155 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 321 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $4,460 | Total amount of fees paid to insurance company | USD $2,121 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,460 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2121 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 9 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 12 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $150 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,501 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $150 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 ) |
Policy contract number | 09472 |
Policy instance | 8 |
Insurance contract or identification number | 09472 | Number of Individuals Covered | 417 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $70,691 | Total amount of fees paid to insurance company | USD $0 | Health 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 $70,691 | Insurance broker organization code? | 3 |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 7 |
Insurance contract or identification number | 0000019776 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674 |
Policy instance | 5 |
Insurance contract or identification number | 51674 | Number of Individuals Covered | 240 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $14,671 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $181,416 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,671 | Insurance broker organization code? | 3 |
|
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 233 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,867 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $38,667 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,867 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 141 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $7,193 | Total amount of fees paid to insurance company | USD $2,106 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D-VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $64,886 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,193 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2106 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 321 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $4,553 | Total amount of fees paid to insurance company | USD $1,725 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,308 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,553 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1725 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 321 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $4,237 | Total amount of fees paid to insurance company | USD $2,132 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $68,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,237 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2132 | Additional information about fees paid to insurance broker | OTHER COMPENSATION |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AFAY |
Policy instance | 2 |
Insurance contract or identification number | GLUG0AFAY | Number of Individuals Covered | 291 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,258 | Total amount of fees paid to insurance company | USD $3,870 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $60,333 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,258 | Amount paid for insurance broker fees | 2838 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AFAY |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AFAY | Number of Individuals Covered | 291 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,262 | Total amount of fees paid to insurance company | USD $2,863 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,249 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,262 | Amount paid for insurance broker fees | 2100 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AFAY |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AFAY | Number of Individuals Covered | 132 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $6,656 | Total amount of fees paid to insurance company | USD $3,636 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D-VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $55,926 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,656 | Amount paid for insurance broker fees | 2666 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 ) |
Policy contract number | 51674 |
Policy instance | 5 |
Insurance contract or identification number | 51674 | Number of Individuals Covered | 226 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $12,844 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $154,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,844 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SVCS - WICHITA |
|
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00001 |
Policy instance | 6 |
Insurance contract or identification number | 51674-000-00001 | Number of Individuals Covered | 214 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,357 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,566 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,357 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SVCS - WICHITA |
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CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
Policy contract number | 0000019776 |
Policy instance | 7 |
Insurance contract or identification number | 0000019776 | Number of Individuals Covered | 151 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $12,140 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $58,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,692 | Insurance broker organization code? | 3 | Insurance broker name | KENNETH D MORRIS, JR |
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BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 ) |
Policy contract number | 09472 |
Policy instance | 8 |
Insurance contract or identification number | 09472 | Number of Individuals Covered | 405 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $60,496 | Total amount of fees paid to insurance company | USD $0 | Health 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 $60,496 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES |
|
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 ) |
Policy contract number | 51674-000-00003 |
Policy instance | 9 |
Insurance contract or identification number | 51674-000-00003 | Number of Individuals Covered | 11 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $133 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $133 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SVCS - WICHITA |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUG0AFAY |
Policy instance | 1 |
Insurance contract or identification number | GUG0AFAY | Number of Individuals Covered | 291 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,139 | Total amount of fees paid to insurance company | USD $3,506 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,139 | Amount paid for insurance broker fees | 2571 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
|