Insurance contract or identification number | GLUG0C2JS |
Number of Individuals Covered | 161 |
Insurance policy start date | 2023-01-01 |
Insurance policy end date | 2023-12-31 |
Total amount of commissions paid to insurance broker | USD $563 |
Total amount of fees paid to insurance company | USD $28 |
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 $3,751 |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |