CMG CIT ACQUISITION, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan COREMEDICAL GROUP EMPLOYEE WELFARE BENEFIT PLAN
401k plan membership statisitcs for COREMEDICAL GROUP EMPLOYEE WELFARE BENEFIT PLAN
LEGALPLANS, USA (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | LEGAL |
Policy instance | 9 |
Insurance contract or identification number | LEGAL | Number of Individuals Covered | 187 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of fees paid to insurance company | USD $1,545 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $10,299 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) |
Policy contract number | G1820 |
Policy instance | 1 |
Insurance contract or identification number | G1820 | Number of Individuals Covered | 1333 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $189,929 | Total amount of fees paid to insurance company | USD $2,782 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,362,428 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 ) |
Policy contract number | 000901778 |
Policy instance | 2 |
Insurance contract or identification number | 000901778 | Number of Individuals Covered | 1104 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $6,502 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,330 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 897488G |
Policy instance | 3 |
Insurance contract or identification number | 897488G | Number of Individuals Covered | 1512 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $66,100 | Total amount of fees paid to insurance company | USD $18,128 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, ACCIDENT, VOL: CI AND HI | Welfare Benefit Premiums Paid to Carrier | USD $470,334 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299411P |
Policy instance | 4 |
Insurance contract or identification number | 299411P | Number of Individuals Covered | 7 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $468 | Total amount of fees paid to insurance company | USD $14 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,648 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225641 |
Policy instance | 5 |
Insurance contract or identification number | 0225641 | Number of Individuals Covered | 298 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $12,220 | Total amount of fees paid to insurance company | USD $867 | Other welfare benefits provided | CII | Welfare Benefit Premiums Paid to Carrier | USD $53,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225642 |
Policy instance | 6 |
Insurance contract or identification number | 0225642 | Number of Individuals Covered | 381 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $6,980 | Total amount of fees paid to insurance company | USD $530 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,377 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225643 |
Policy instance | 7 |
Insurance contract or identification number | 0225643 | Number of Individuals Covered | 231 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $16,524 | Total amount of fees paid to insurance company | USD $1,135 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,965 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 8210010 |
Policy instance | 8 |
Insurance contract or identification number | 8210010 | Number of Individuals Covered | 163 | Insurance policy start date | 2023-01-01 | Insurance policy end date | 2023-12-31 | Total amount of commissions paid to insurance broker | USD $3,011 | Total amount of fees paid to insurance company | USD $415 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $42,021 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 628606 |
Policy instance | 5 |
Insurance contract or identification number | 628606 | Number of Individuals Covered | 540 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-06-01 | Total amount of commissions paid to insurance broker | USD $16,098 | Total amount of fees paid to insurance company | USD $2,146 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,098 | Amount paid for insurance broker fees | 2146 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 ) |
Policy contract number | 000901778 |
Policy instance | 4 |
Insurance contract or identification number | 000901778 | Number of Individuals Covered | 1155 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6,442 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,602 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574588 |
Policy instance | 3 |
Insurance contract or identification number | 574588 | Number of Individuals Covered | 1509 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-06-01 | Total amount of commissions paid to insurance broker | USD $3,690 | Total amount of fees paid to insurance company | USD $747 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $37,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,690 | Amount paid for insurance broker fees | 747 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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MATTHEW THORNTON HEALTH PLAN INC. (National Association of Insurance Commissioners NAIC id number: 95527 ) |
Policy contract number | G1822 |
Policy instance | 2 |
Insurance contract or identification number | G1822 | Number of Individuals Covered | 200 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,304,765 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) |
Policy contract number | G1820 |
Policy instance | 1 |
Insurance contract or identification number | G1820 | Number of Individuals Covered | 1431 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $131,796 | Total amount of fees paid to insurance company | USD $2,019 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,118,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $131,796 | Amount paid for insurance broker fees | 2019 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 218135 |
Policy instance | 6 |
Insurance contract or identification number | 218135 | Number of Individuals Covered | 511 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-06-01 | Total amount of commissions paid to insurance broker | USD $12,406 | Total amount of fees paid to insurance company | USD $1,654 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $124,172 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,406 | Amount paid for insurance broker fees | 1654 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 897488G |
Policy instance | 7 |
Insurance contract or identification number | 897488G | Number of Individuals Covered | 1577 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $22,774 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $133,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,774 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299411P |
Policy instance | 8 |
Insurance contract or identification number | 299411P | Number of Individuals Covered | 2 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $87 | Total amount of fees paid to insurance company | USD $19 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $87 | Amount paid for insurance broker fees | 19 | Additional information about fees paid to insurance broker | BONUS |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225641 |
Policy instance | 9 |
Insurance contract or identification number | 0225641 | Number of Individuals Covered | 402 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $21,692 | Total amount of fees paid to insurance company | USD $1,804 | Other welfare benefits provided | CII | Welfare Benefit Premiums Paid to Carrier | USD $97,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,692 | Amount paid for insurance broker fees | 1804 | Additional information about fees paid to insurance broker | NON-MONETARY/SUPPLEMENTAL COMP. MARKETING FEES | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225642 |
Policy instance | 10 |
Insurance contract or identification number | 0225642 | Number of Individuals Covered | 488 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $7,355 | Total amount of fees paid to insurance company | USD $711 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,027 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,355 | Amount paid for insurance broker fees | 711 | Additional information about fees paid to insurance broker | NON-MONETARY/SUPPLEMENTAL COMP. MARKETING FEES | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225643 |
Policy instance | 11 |
Insurance contract or identification number | 0225643 | Number of Individuals Covered | 338 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $20,837 | Total amount of fees paid to insurance company | USD $1,822 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $106,177 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,837 | Amount paid for insurance broker fees | 1822 | Additional information about fees paid to insurance broker | NON-MONETARY/SUPPLEMENTAL COMP. MARKETING FEES | Insurance broker organization code? | 3 |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 8210010 |
Policy instance | 12 |
Insurance contract or identification number | 8210010 | Number of Individuals Covered | 158 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,667 | Total amount of fees paid to insurance company | USD $722 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $42,147 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,667 | Amount paid for insurance broker fees | 722 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 218135 |
Policy instance | 7 |
Insurance contract or identification number | 218135 | Number of Individuals Covered | 326 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $14,061 | Total amount of fees paid to insurance company | USD $1,875 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $93,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,061 | Amount paid for insurance broker fees | 1875 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
Policy contract number | 4687 |
Policy instance | 8 |
Insurance contract or identification number | 4687 | Number of Individuals Covered | 1 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $510 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,915 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $510 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299411P |
Policy instance | 9 |
Insurance contract or identification number | 299411P | Number of Individuals Covered | 8 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $200 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,002 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $200 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225641 |
Policy instance | 10 |
Insurance contract or identification number | 0225641 | Number of Individuals Covered | 358 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $11,186 | Total amount of fees paid to insurance company | USD $770 | Other welfare benefits provided | CII | Welfare Benefit Premiums Paid to Carrier | USD $71,742 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,186 | Amount paid for insurance broker fees | 770 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225642 |
Policy instance | 11 |
Insurance contract or identification number | 0225642 | Number of Individuals Covered | 408 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $6,980 | Total amount of fees paid to insurance company | USD $507 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,673 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,980 | Amount paid for insurance broker fees | 507 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225643 |
Policy instance | 12 |
Insurance contract or identification number | 0225643 | Number of Individuals Covered | 318 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $14,962 | Total amount of fees paid to insurance company | USD $1,006 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,607 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,962 | Amount paid for insurance broker fees | 1006 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 628606 |
Policy instance | 6 |
Insurance contract or identification number | 628606 | Number of Individuals Covered | 450 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $20,220 | Total amount of fees paid to insurance company | USD $2,696 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $134,801 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,220 | Amount paid for insurance broker fees | 2696 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122658 |
Policy instance | 5 |
Insurance contract or identification number | 122658 | Number of Individuals Covered | 19 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $407 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $2,384 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $407 | Insurance broker organization code? | 3 |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 8210010 |
Policy instance | 13 |
Insurance contract or identification number | 8210010 | Number of Individuals Covered | 155 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,011 | Total amount of fees paid to insurance company | USD $71 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $31,080 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,011 | Amount paid for insurance broker fees | 71 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) |
Policy contract number | G1820 |
Policy instance | 1 |
Insurance contract or identification number | G1820 | Number of Individuals Covered | 1208 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $99,339 | Total amount of fees paid to insurance company | USD $8,511 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,025,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $99,339 | Amount paid for insurance broker fees | 8511 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
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MATTHEW THORNTON HEALTH PLAN INC. (National Association of Insurance Commissioners NAIC id number: 95527 ) |
Policy contract number | G1822 |
Policy instance | 2 |
Insurance contract or identification number | G1822 | Number of Individuals Covered | 193 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $961,597 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574588 |
Policy instance | 3 |
Insurance contract or identification number | 574588 | Number of Individuals Covered | 1013 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $6,048 | Total amount of fees paid to insurance company | USD $1,301 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $65,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,048 | Amount paid for insurance broker fees | 1301 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 ) |
Policy contract number | 000901778 |
Policy instance | 4 |
Insurance contract or identification number | 000901778 | Number of Individuals Covered | 1027 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,590 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,358 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,991 | Insurance broker organization code? | 3 |
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ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) |
Policy contract number | G1820 |
Policy instance | 1 |
Insurance contract or identification number | G1820 | Number of Individuals Covered | 513 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $138,813 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,002,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $138,813 | Insurance broker organization code? | 3 |
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MATTHEW THORNTON HEALTH PLAN INC. (National Association of Insurance Commissioners NAIC id number: 95527 ) |
Policy contract number | G1822 |
Policy instance | 2 |
Insurance contract or identification number | G1822 | Number of Individuals Covered | 163 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $969,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574588 |
Policy instance | 3 |
Insurance contract or identification number | 574588 | Number of Individuals Covered | 777 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $5,269 | Total amount of fees paid to insurance company | USD $1,028 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $51,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,269 | Amount paid for insurance broker fees | 1028 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 ) |
Policy contract number | 000001778 |
Policy instance | 4 |
Insurance contract or identification number | 000001778 | Number of Individuals Covered | 772 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $6,777 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $242,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,479 | Insurance broker organization code? | 3 |
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RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 ) |
Policy contract number | 000901778 |
Policy instance | 5 |
Insurance contract or identification number | 000901778 | Number of Individuals Covered | 650 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,643 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,168 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122658 |
Policy instance | 6 |
Insurance contract or identification number | 122658 | Number of Individuals Covered | 19 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $432 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $2,878 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $432 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 628606 |
Policy instance | 7 |
Insurance contract or identification number | 628606 | Number of Individuals Covered | 210 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $13,539 | Total amount of fees paid to insurance company | USD $1,805 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $90,262 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,539 | Amount paid for insurance broker fees | 1805 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 218135 |
Policy instance | 8 |
Insurance contract or identification number | 218135 | Number of Individuals Covered | 177 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $12,131 | Total amount of fees paid to insurance company | USD $1,617 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $80,870 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,131 | Amount paid for insurance broker fees | 1617 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 8210010 |
Policy instance | 14 |
Insurance contract or identification number | 8210010 | Number of Individuals Covered | 73 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,617 | Total amount of fees paid to insurance company | USD $166 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $17,598 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,617 | Amount paid for insurance broker fees | 166 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225643 |
Policy instance | 13 |
Insurance contract or identification number | 0225643 | Number of Individuals Covered | 189 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $8,644 | Total amount of fees paid to insurance company | USD $593 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $57,663 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,644 | Amount paid for insurance broker fees | 593 | Additional information about fees paid to insurance broker | SUPPLEMENTAL/NON-MONETARY COMP. MARKETING FEES | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225642 |
Policy instance | 12 |
Insurance contract or identification number | 0225642 | Number of Individuals Covered | 243 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,176 | Total amount of fees paid to insurance company | USD $251 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,176 | Amount paid for insurance broker fees | 251 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0225641 |
Policy instance | 11 |
Insurance contract or identification number | 0225641 | Number of Individuals Covered | 186 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $7,233 | Total amount of fees paid to insurance company | USD $505 | Other welfare benefits provided | CII | Welfare Benefit Premiums Paid to Carrier | USD $40,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,233 | Amount paid for insurance broker fees | 505 | Additional information about fees paid to insurance broker | SUPPLEMENTAL/NON-MONETARY COMP. MARKETING FEES | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 299411P |
Policy instance | 10 |
Insurance contract or identification number | 299411P | Number of Individuals Covered | 13 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $240 | Total amount of fees paid to insurance company | USD $30 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $240 | Amount paid for insurance broker fees | 30 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
Policy contract number | 4687 |
Policy instance | 9 |
Insurance contract or identification number | 4687 | Number of Individuals Covered | 5 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,712 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MATTHEW THORNTON HEALTH PLAN INC. (National Association of Insurance Commissioners NAIC id number: 95527 ) |
Policy contract number | G1822 |
Policy instance | 2 |
Insurance contract or identification number | G1822 | Number of Individuals Covered | 161 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $958,152 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 574588 |
Policy instance | 3 |
Insurance contract or identification number | 574588 | Number of Individuals Covered | 871 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $5,874 | Total amount of fees paid to insurance company | USD $1,205 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $60,256 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,874 | Amount paid for insurance broker fees | 1205 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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NORTHEAST DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 47079 ) |
Policy contract number | 000001778 |
Policy instance | 4 |
Insurance contract or identification number | 000001778 | Number of Individuals Covered | 776 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $8,124 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $301,551 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,571 | Insurance broker organization code? | 3 |
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RED TREE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 13646 ) |
Policy contract number | 000901778 |
Policy instance | 5 |
Insurance contract or identification number | 000901778 | Number of Individuals Covered | 687 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,346 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,449 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,779 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 122658 |
Policy instance | 6 |
Insurance contract or identification number | 122658 | Number of Individuals Covered | 18 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $391 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $2,608 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $391 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 628606 |
Policy instance | 7 |
Insurance contract or identification number | 628606 | Number of Individuals Covered | 287 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $15,653 | Total amount of fees paid to insurance company | USD $2,087 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,356 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,653 | Amount paid for insurance broker fees | 2087 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 218135 |
Policy instance | 8 |
Insurance contract or identification number | 218135 | Number of Individuals Covered | 253 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $10,654 | Total amount of fees paid to insurance company | USD $1,421 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $71,030 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,654 | Amount paid for insurance broker fees | 1421 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
Policy contract number | 4687 |
Policy instance | 9 |
Insurance contract or identification number | 4687 | Number of Individuals Covered | 11 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $108,119 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 ) |
Policy contract number | G1820 |
Policy instance | 1 |
Insurance contract or identification number | G1820 | Number of Individuals Covered | 570 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $166,514 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,699,455 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $166,514 | Insurance broker organization code? | 3 |
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