401k Plan data: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN plan

WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 401k Plan overview

Plan Name	WEIGEL BROADCASTING COMPANY CAFETERIA PLAN
Plan identification number	501

WEIGEL BROADCASTING COMPANY CAFETERIA PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

WEIGEL BROADCASTING CO. has sponsored the creation of one or more 401k plans.

Company Name: WEIGEL BROADCASTING CO.

Employer identification number (EIN): 362497545

NAIC Classification: 515100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WEIGEL BROADCASTING COMPANY CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 ALVIN PRITCHARD 2023-10-13
501 2021-01-01 NORMAN SHAPIRO 2022-10-12
501 2020-01-01 NORMAN SHAPIRO 2021-10-11
501 2019-01-01 NORMAN SHAPIRO 2020-10-13
501 2018-01-01 NORMAN SHAPIRO 2019-10-14
501 2017-01-01
501 2016-01-01
501 2015-01-01
501 2014-01-01
501 2013-01-01
501 2012-01-01 NORMAN SHAPIRO
501 2011-01-01 LILLI SCHEYE
501 2009-01-01 HOWARD SHAPIRO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2022-01-01	ALVIN PRITCHARD	2023-10-13
501	2021-01-01	NORMAN SHAPIRO	2022-10-12
501	2020-01-01	NORMAN SHAPIRO	2021-10-11
501	2019-01-01	NORMAN SHAPIRO	2020-10-13
501	2018-01-01	NORMAN SHAPIRO	2019-10-14
501	2017-01-01
501	2016-01-01
501	2015-01-01
501	2014-01-01
501	2013-01-01
501	2012-01-01	NORMAN SHAPIRO
501	2011-01-01	LILLI SCHEYE
501	2009-01-01	HOWARD SHAPIRO

Plan Statistics for WEIGEL BROADCASTING COMPANY CAFETERIA PLAN

401k plan membership statisitcs for WEIGEL BROADCASTING COMPANY CAFETERIA PLAN

Measure Date Value
2022: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 335
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 348
Total of all active and inactive participants 2022-01-01 348
2021: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 337
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 335
Total of all active and inactive participants 2021-01-01 335
2020: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 333
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 337
Total of all active and inactive participants 2020-01-01 337
2019: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 310
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 333
Total of all active and inactive participants 2019-01-01 333
2018: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 311
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 310
Total of all active and inactive participants 2018-01-01 310
2017: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 311
Total of all active and inactive participants 2017-01-01 311
2016: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 275
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 301
Total of all active and inactive participants 2016-01-01 301
2015: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 290
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 275
Total of all active and inactive participants 2015-01-01 275
2014: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 290
Total of all active and inactive participants 2014-01-01 290
2013: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 258
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 269
Total of all active and inactive participants 2013-01-01 269
2012: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 244
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 258
Total of all active and inactive participants 2012-01-01 258
2011: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 244
Total of all active and inactive participants 2011-01-01 244
2009: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 197
Total of all active and inactive participants 2009-01-01 197

Measure	Date	Value
2022: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	335
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	348
Total of all active and inactive participants	2022-01-01	348
2021: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	337
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	335
Total of all active and inactive participants	2021-01-01	335
2020: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	333
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	337
Total of all active and inactive participants	2020-01-01	337
2019: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	310
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	333
Total of all active and inactive participants	2019-01-01	333
2018: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	311
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	310
Total of all active and inactive participants	2018-01-01	310
2017: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	311
Total of all active and inactive participants	2017-01-01	311
2016: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	275
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	301
Total of all active and inactive participants	2016-01-01	301
2015: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	290
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	275
Total of all active and inactive participants	2015-01-01	275
2014: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	290
Total of all active and inactive participants	2014-01-01	290
2013: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	258
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	269
Total of all active and inactive participants	2013-01-01	269
2012: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	244
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	258
Total of all active and inactive participants	2012-01-01	258
2011: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	244
Total of all active and inactive participants	2011-01-01	244
2009: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	197
Total of all active and inactive participants	2009-01-01	197

Form 5500 Responses for WEIGEL BROADCASTING COMPANY CAFETERIA PLAN

2022: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: WEIGEL BROADCASTING COMPANY CAFETERIA PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010257764

Policy instance

Insurance contract or identification number	000010257764
Number of Individuals Covered	490
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $89
Total amount of fees paid to insurance company	USD $272
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $15,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	226
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	123
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	4

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172533

Policy instance

Insurance contract or identification number	172533
Number of Individuals Covered	499
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,340
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,305,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	3340
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

ER00029732

Policy instance

Insurance contract or identification number	ER00029732
Number of Individuals Covered	217
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $8,245
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $42,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,437
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	577
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,531
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $205,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,531
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	577
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,531
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $205,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,531
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

ER00029732

Policy instance

Insurance contract or identification number	ER00029732
Number of Individuals Covered	204
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $10,370
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $48,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,174
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172533

Policy instance

Insurance contract or identification number	172533
Number of Individuals Covered	483
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 $3,390
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,033,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	3390
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	123
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010257764

Policy instance

Insurance contract or identification number	000010257764
Number of Individuals Covered	464
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 $261
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $9,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	138
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	595
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $183,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

ER00029732

Policy instance

Insurance contract or identification number	ER00029732
Number of Individuals Covered	164
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $10,155
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $30,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,402
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172533

Policy instance

Insurance contract or identification number	172533
Number of Individuals Covered	472
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,240
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,965,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2240
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	124
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $92,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010257764

Policy instance

Insurance contract or identification number	000010257764
Number of Individuals Covered	467
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $606
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $12,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	606
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	506
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $6,982
Total amount of fees paid to insurance company	USD $4,574
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,186,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,978
Amount paid for insurance broker fees	4569
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

000035567

Policy instance

Insurance contract or identification number	000035567
Number of Individuals Covered	138
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7,595
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,079
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172533

Policy instance

Insurance contract or identification number	172533
Number of Individuals Covered	324
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $12
Total amount of fees paid to insurance company	USD $2,140
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,770,908
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
Amount paid for insurance broker fees	2140
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	166
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $115,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	479
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $6,762
Total amount of fees paid to insurance company	USD $23,673
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,036,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,047
Amount paid for insurance broker fees	23673
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

000035567

Policy instance

Insurance contract or identification number	000035567
Number of Individuals Covered	123
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $6,288
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,288
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172533

Policy instance

Insurance contract or identification number	172533
Number of Individuals Covered	304
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $50,218
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,631,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,176
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	166
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $115,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	299
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $16,914
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $109,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,914
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

172534

Policy instance

Insurance contract or identification number	172534
Number of Individuals Covered	304
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $49,118
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,461,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,118
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

000035567

Policy instance

Insurance contract or identification number	000035567
Number of Individuals Covered	93
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $11,005
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $18,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,005
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	461
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $6,527
Total amount of fees paid to insurance company	USD $16,813
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $735,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,527
Amount paid for insurance broker fees	16813
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0904561

Policy instance

Insurance contract or identification number	0904561
Number of Individuals Covered	641
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,801
Total amount of fees paid to insurance company	USD $32,202
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,307,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,801
Amount paid for insurance broker fees	32202
Additional information about fees paid to insurance broker	SERVICE FEE AGREEMENT
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE AGENCY, INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0869520

Policy instance

Insurance contract or identification number	0869520
Number of Individuals Covered	140
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $9,400
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $534,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	9400
Additional information about fees paid to insurance broker	ILLINOIS MM BROKER BONUS PROGRAM 10-1-14 - 4-1-15
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

304110

Policy instance

Insurance contract or identification number	304110
Number of Individuals Covered	276
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $14,390
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $103,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,390
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

554212

Policy instance

Insurance contract or identification number	554212
Number of Individuals Covered	94
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $14,412
Total amount of fees paid to insurance company	USD $1,961
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 $653,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,412
Amount paid for insurance broker fees	1524
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

Q9999

Policy instance

Insurance contract or identification number	Q9999
Number of Individuals Covered	73
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,047
Total amount of fees paid to insurance company	USD $1,191
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 $435,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,928
Amount paid for insurance broker fees	1191
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0753341

Policy instance

Insurance contract or identification number	0753341
Number of Individuals Covered	124
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,726
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 $536,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,726
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

KR720

Policy instance

Insurance contract or identification number	KR720
Number of Individuals Covered	295
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,778
Total amount of fees paid to insurance company	USD $8,811
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $186,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,685
Amount paid for insurance broker fees	8811
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

KR720

Policy instance

Insurance contract or identification number	KR720
Number of Individuals Covered	287
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $12,937
Total amount of fees paid to insurance company	USD $8,480
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $186,480
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,937
Amount paid for insurance broker fees	8480
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

Q9999

Policy instance

Insurance contract or identification number	Q9999
Number of Individuals Covered	72
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11,929
Total amount of fees paid to insurance company	USD $1,964
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 $395,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,929
Amount paid for insurance broker fees	1964
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0753341

Policy instance

Insurance contract or identification number	0753341
Number of Individuals Covered	121
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $14,831
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 $457,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,831
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

554212

Policy instance

Insurance contract or identification number	554212
Number of Individuals Covered	92
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $17,674
Total amount of fees paid to insurance company	USD $2,809
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 $595,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,674
Amount paid for insurance broker fees	2809
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

Q9999

Policy instance

Insurance contract or identification number	Q9999
Number of Individuals Covered	69
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $13,054
Total amount of fees paid to insurance company	USD $1,463
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 $361,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,054
Amount paid for insurance broker fees	1463
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

554212

Policy instance

Insurance contract or identification number	554212
Number of Individuals Covered	87
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $16,759
Total amount of fees paid to insurance company	USD $1,801
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 $569,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,759
Amount paid for insurance broker fees	1801
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

KR720

Policy instance

Insurance contract or identification number	KR720
Number of Individuals Covered	271
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $12,537
Total amount of fees paid to insurance company	USD $7,519
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $175,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,537
Amount paid for insurance broker fees	7519
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

629472

Policy instance

Insurance contract or identification number	629472
Number of Individuals Covered	82
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $12,785
Total amount of fees paid to insurance company	USD $1,703
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 $425,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,785
Amount paid for insurance broker fees	1703
Additional information about fees paid to insurance broker	VOLUME BONUS
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

Q9999

Policy instance

Insurance contract or identification number	Q9999
Number of Individuals Covered	66
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $17,006
Total amount of fees paid to insurance company	USD $1,504
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 $360,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

554212

Policy instance

Insurance contract or identification number	554212
Number of Individuals Covered	83
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $21,133
Total amount of fees paid to insurance company	USD $1,831
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 $490,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

KR720

Policy instance

Insurance contract or identification number	KR720
Number of Individuals Covered	260
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $12,127
Total amount of fees paid to insurance company	USD $5,647
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $143,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

629472

Policy instance

Insurance contract or identification number	629472
Number of Individuals Covered	80
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $20,360
Total amount of fees paid to insurance company	USD $1,885
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 $377,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

629472

Policy instance

Insurance contract or identification number	629472
Number of Individuals Covered	81
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $20,844
Total amount of fees paid to insurance company	USD $1,396
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 $368,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,844
Amount paid for insurance broker fees	1396
Additional information about fees paid to insurance broker	VOLUME BONUS AND SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

KR720

Policy instance

Insurance contract or identification number	KR720
Number of Individuals Covered	217
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $9,381
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
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $111,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,381
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

554212

Policy instance

Insurance contract or identification number	554212
Number of Individuals Covered	57
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $21,163
Total amount of fees paid to insurance company	USD $963
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 $352,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,163
Amount paid for insurance broker fees	963
Additional information about fees paid to insurance broker	VOLUME BONUS AND SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )

Policy contract number

Q9999

Policy instance

Insurance contract or identification number	Q9999
Number of Individuals Covered	56
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $13,906
Total amount of fees paid to insurance company	USD $850
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 $292,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,906
Amount paid for insurance broker fees	850
Additional information about fees paid to insurance broker	VOLUME BONUS AND SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LINDEN GROUP HEALTH SERVICES INC

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Company Name:	WEIGEL BROADCASTING CO.
Employer identification number (EIN):	362497545
NAIC Classification:	515100