GENESIS PLASTICS AND ENGINEERING, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN
401k plan membership statisitcs for GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN
| Measure | Date | Value |
|---|
| 2017: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 125 |
| Total of all active and inactive participants | 2017-01-01 | 125 |
| 2016: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 135 |
| Total of all active and inactive participants | 2016-01-01 | 135 |
| 2015: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 154 |
| Total of all active and inactive participants | 2015-01-01 | 154 |
| 2014: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 145 |
| Total of all active and inactive participants | 2014-01-01 | 145 |
| 2013: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 156 |
| Total of all active and inactive participants | 2013-01-01 | 156 |
| 2012: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 119 |
| Total of all active and inactive participants | 2012-01-01 | 119 |
| 2009: GENESIS PLASTICS AND ENGINEERING LLC WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 94 |
| Total of all active and inactive participants | 2009-01-01 | 94 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 30790-1627 |
| Policy instance | 5 |
| Insurance contract or identification number | 30790-1627 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-03-31 | | Total amount of commissions paid to insurance broker | USD $1,646 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,097 | | Insurance broker organization code? | 3 | | Insurance broker name | PLANCHOICE INC. |
|
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | 417004411178 |
| Policy instance | 4 |
| Insurance contract or identification number | 417004411178 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-04-01 | | Total amount of commissions paid to insurance broker | USD $10,743 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,140 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,743 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 ) |
| Policy contract number | 04780801/802 |
| Policy instance | 3 |
| Insurance contract or identification number | 04780801/802 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-03-31 | | Total amount of commissions paid to insurance broker | USD $4,436 | | Total amount of fees paid to insurance company | USD $0 | | Dental 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 $4,436 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 602490 |
| Policy instance | 2 |
| Insurance contract or identification number | 602490 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-04-01 | | Total amount of commissions paid to insurance broker | USD $1,285 | | Total amount of fees paid to insurance company | USD $64 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $8,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,285 | | Amount paid for insurance broker fees | 64 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 602491 |
| Policy instance | 1 |
| Insurance contract or identification number | 602491 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2016-04-01 | | Insurance policy end date | 2017-04-01 | | Total amount of commissions paid to insurance broker | USD $2,966 | | Total amount of fees paid to insurance company | USD $148 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $19,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,966 | | Amount paid for insurance broker fees | 148 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | BP0140 |
| Policy instance | 1 |
| Insurance contract or identification number | BP0140 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $2,358 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,435 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,358 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | BP0140 |
| Policy instance | 2 |
| Insurance contract or identification number | BP0140 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $1,661 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $10,054 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,661 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | BP0140 |
| Policy instance | 3 |
| Insurance contract or identification number | BP0140 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $4,752 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,752 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 417003411178 |
| Policy instance | 4 |
| Insurance contract or identification number | 417003411178 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-04-01 | | Total amount of commissions paid to insurance broker | USD $13,794 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,794 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 30790-1627(1) |
| Policy instance | 5 |
| Insurance contract or identification number | 30790-1627(1) | | Number of Individuals Covered | 233 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $2,197 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,465 | | Insurance broker organization code? | 3 | | Insurance broker name | PLAN CHOICE |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 30790-1627(1) |
| Policy instance | 5 |
| Insurance contract or identification number | 30790-1627(1) | | Number of Individuals Covered | 214 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $1,952 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,301 | | Insurance broker organization code? | 3 | | Insurance broker name | PLAN CHOICE |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 417003411178 |
| Policy instance | 4 |
| Insurance contract or identification number | 417003411178 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-04-01 | | Total amount of commissions paid to insurance broker | USD $12,405 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $136,505 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,405 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 3 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $3,904 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,798 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,904 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 2 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 310 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $1,706 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $9,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,706 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 1 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $2,712 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,786 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,712 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 2 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 429 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,371 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $9,030 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,371 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 3 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $3,611 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,611 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417002411178 |
| Policy instance | 4 |
| Insurance contract or identification number | 417002411178 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-04-01 | | Total amount of commissions paid to insurance broker | USD $12,725 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,725 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 30790-1627(1) |
| Policy instance | 5 |
| Insurance contract or identification number | 30790-1627(1) | | Number of Individuals Covered | 205 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,861 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,409 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,241 | | Insurance broker organization code? | 3 | | Insurance broker name | PLAN CHOICE |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 1 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $2,517 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,542 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,517 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
| Policy contract number | 00209769 |
| Policy instance | 2 |
| Insurance contract or identification number | 00209769 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $28,960 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $735,417 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,960 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 3 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $2,586 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,586 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 4 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $3,358 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,358 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
| Policy contract number | 8500V8 |
| Policy instance | 1 |
| Insurance contract or identification number | 8500V8 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,158 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,833 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,158 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN AND BROWN OF KENTUCKY |
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