MCKENDREE UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MCKENDREE COLLEGE WELFARE PLAN
Measure | Date | Value |
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2022: MCKENDREE COLLEGE WELFARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 268 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 269 |
Total of all active and inactive participants | 2022-01-01 | 269 |
2021: MCKENDREE COLLEGE WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 276 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 268 |
Total of all active and inactive participants | 2021-01-01 | 268 |
2020: MCKENDREE COLLEGE WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 296 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 276 |
Total of all active and inactive participants | 2020-01-01 | 276 |
2019: MCKENDREE COLLEGE WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 321 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 296 |
Total of all active and inactive participants | 2019-01-01 | 296 |
2018: MCKENDREE COLLEGE WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 354 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 321 |
Total of all active and inactive participants | 2018-01-01 | 321 |
2017: MCKENDREE COLLEGE WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 354 |
Total of all active and inactive participants | 2017-01-01 | 354 |
2016: MCKENDREE COLLEGE WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 299 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 289 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 8 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 297 |
2015: MCKENDREE COLLEGE WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 199 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 299 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 299 |
2014: MCKENDREE COLLEGE WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 178 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 199 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 199 |
2013: MCKENDREE COLLEGE WELFARE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 337 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 341 |
Total of all active and inactive participants | 2013-01-01 | 341 |
Total participants | 2013-01-01 | 0 |
2012: MCKENDREE COLLEGE WELFARE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 270 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 337 |
Total of all active and inactive participants | 2012-01-01 | 337 |
Total participants | 2012-01-01 | 0 |
2011: MCKENDREE COLLEGE WELFARE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 255 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 270 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 270 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
Total participants | 2011-01-01 | 270 |
2010: MCKENDREE COLLEGE WELFARE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 249 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 255 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
Total of all active and inactive participants | 2010-01-01 | 255 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
Total participants | 2010-01-01 | 255 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
2009: MCKENDREE COLLEGE WELFARE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 249 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 249 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 249 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
Total participants | 2009-01-01 | 249 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
2022: MCKENDREE COLLEGE WELFARE PLAN 2022 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2021 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2020 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2019 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2018 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2017 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: MCKENDREE COLLEGE WELFARE PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: MCKENDREE COLLEGE WELFARE PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: MCKENDREE COLLEGE WELFARE PLAN 2013 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2012 form 5500 responses |
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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: MCKENDREE COLLEGE WELFARE PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | First time form 5500 has been submitted | Yes |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2010: MCKENDREE COLLEGE WELFARE PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | First time form 5500 has been submitted | Yes |
2010-01-01 | Submission has been amended | No |
2010-01-01 | This submission is the final filing | No |
2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-01-01 | Plan is a collectively bargained plan | No |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: MCKENDREE COLLEGE WELFARE PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | First time form 5500 has been submitted | Yes |
2009-01-01 | Submission has been amended | Yes |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 112 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,294 | Total amount of fees paid to insurance company | USD $718 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,294 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 718 | Additional information about fees paid to insurance broker | COMMISSION |
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DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 154 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,857 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 3 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 213 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,234 | Total amount of fees paid to insurance company | USD $865 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,234 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 865 | Additional information about fees paid to insurance broker | ADMINISTRATION |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 2 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 269 | 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 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $61,018 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 1 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 210 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,485 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL662290 |
Policy instance | 6 |
Insurance contract or identification number | ABL662290 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | 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 $3,564 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,564 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 2 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 268 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $63,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 3 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 219 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,356 | Total amount of fees paid to insurance company | USD $887 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,356 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 887 | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 158 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL662290 |
Policy instance | 6 |
Insurance contract or identification number | ABL662290 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 1 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 235 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 1 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 270 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,506 | 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 | 90567 |
Policy instance | 2 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 276 | 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 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $59,254 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 3 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 225 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,621 | Total amount of fees paid to insurance company | USD $961 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,621 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 961 | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 170 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $9,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 148 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,018 | Total amount of fees paid to insurance company | USD $869 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,018 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 869 | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL662290 |
Policy instance | 6 |
Insurance contract or identification number | ABL662290 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 1 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 286 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,292 | 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 | 90567 |
Policy instance | 2 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 296 | 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 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $65,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 3 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 257 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,339 | Total amount of fees paid to insurance company | USD $2,860 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,339 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2860 | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 183 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,843 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 158 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,893 | Total amount of fees paid to insurance company | USD $1,816 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,893 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1816 | Additional information about fees paid to insurance broker | ADMINISTRATION |
|
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL662290 |
Policy instance | 6 |
Insurance contract or identification number | ABL662290 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 1 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 321 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,809 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 2 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 254 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $64,889 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 3 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 256 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,786 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,786 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 198 | 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 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | 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 $4,917 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,971 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT961791 |
Policy instance | 7 |
Insurance contract or identification number | VDT961791 | Number of Individuals Covered | 289 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,046 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 6 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 213 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $11,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 755209 |
Policy instance | 5 |
Insurance contract or identification number | 755209 | Number of Individuals Covered | 274 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $3,630 | Total amount of fees paid to insurance company | USD $1,705 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,630 | Amount paid for insurance broker fees | 1705 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL & INSTITUTIONAL INS ADM |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 4 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 272 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $66,747 | 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 name | VELENCIA, ALDO |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041156 |
Policy instance | 3 |
Insurance contract or identification number | 1041156 | Number of Individuals Covered | 285 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $961 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,012 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $961 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL & INSTITUTIONAL INS ADM |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 98939421001 |
Policy instance | 2 |
Insurance contract or identification number | 98939421001 | Number of Individuals Covered | 336 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,237 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3340611 |
Policy instance | 1 |
Insurance contract or identification number | 3340611 | Number of Individuals Covered | 354 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $41,735 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,303,828 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,735 | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES LLC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | VDT961791 |
Policy instance | 5 |
Insurance contract or identification number | VDT961791 | Number of Individuals Covered | 299 | Insurance policy start date | 2015-11-01 | Insurance policy end date | 2016-10-31 | Total amount of commissions paid to insurance broker | USD $405 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $31,198 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $405 | Insurance broker organization code? | 3 | Insurance broker name | BEATTIE AND ASSOCIATES, INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041156 |
Policy instance | 3 |
Insurance contract or identification number | 1041156 | Number of Individuals Covered | 299 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,771 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $31,427 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,771 | Insurance broker organization code? | 3 | Insurance broker name | EIIA, INC. |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9893942 |
Policy instance | 2 |
Insurance contract or identification number | 9893942 | Number of Individuals Covered | 336 | 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 $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 1 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 385 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $35,616 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,424,652 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,616 | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 4 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 296 | 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 $1,388 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $69,653 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1388 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HOLMES, MURPHY AND ASSOCIATES, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 872222G |
Policy instance | 5 |
Insurance contract or identification number | 872222G | Number of Individuals Covered | 169 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $35,057 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041156 |
Policy instance | 4 |
Insurance contract or identification number | 1041156 | Number of Individuals Covered | 292 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,035 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $27,875 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,035 | Insurance broker organization code? | 3 | Insurance broker name | EIIA, INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9893942 |
Policy instance | 3 |
Insurance contract or identification number | 9893942 | Number of Individuals Covered | 324 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 2 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 220 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 1 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 366 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $33,225 | Total amount of fees paid to insurance company | USD $2,625 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,328,815 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,225 | Amount paid for insurance broker fees | 2625 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HOLMES, MURPHY AND ASSOCIATES, INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 90567 |
Policy instance | 6 |
Insurance contract or identification number | 90567 | Number of Individuals Covered | 281 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,148 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $65,599 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1148 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HOLMES, MURPHY AND ASSOCIATES, INC. |
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DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 206 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,971 | 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 | 090567 |
Policy instance | 5 |
Insurance contract or identification number | 090567 | Number of Individuals Covered | 284 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $-64 | Total amount of fees paid to insurance company | USD $1,061 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $64,875 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $-64 | Amount paid for insurance broker fees | 1061 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | HOLMES MURPHY & ASSOCIATES INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 6 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 341 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $33,162 | Total amount of fees paid to insurance company | USD $3,100 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,106,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,274 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3100 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 872222G |
Policy instance | 2 |
Insurance contract or identification number | 872222G | Number of Individuals Covered | 173 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,886 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | HOLMES MURPHY & ASSOCS INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696914G |
Policy instance | 1 |
Insurance contract or identification number | 696914G | Number of Individuals Covered | 284 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,042 | Total amount of fees paid to insurance company | USD $1,010 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $33,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,042 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1010 | Additional information about fees paid to insurance broker | FEES | Insurance broker name | BB&T INS SERVICES INC |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 553888 |
Policy instance | 3 |
Insurance contract or identification number | 553888 | Number of Individuals Covered | 145 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,091 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 872222G |
Policy instance | 6 |
Insurance contract or identification number | 872222G | Number of Individuals Covered | 172 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,906 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $38,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,906 | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 553888 |
Policy instance | 5 |
Insurance contract or identification number | 553888 | Number of Individuals Covered | 128 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $1,827 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,827 | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) |
Policy contract number | 10131 |
Policy instance | 4 |
Insurance contract or identification number | 10131 | Number of Individuals Covered | 201 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,724 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,876 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,724 | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 090567 |
Policy instance | 3 |
Insurance contract or identification number | 090567 | Number of Individuals Covered | 274 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $11,341 | Total amount of fees paid to insurance company | USD $564 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $76,385 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64 | Amount paid for insurance broker fees | 564 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 2 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 337 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $53,607 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,072,131 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $53,607 | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696914G |
Policy instance | 7 |
Insurance contract or identification number | 696914G | Number of Individuals Covered | 273 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $3,834 | Total amount of fees paid to insurance company | USD $1,631 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $31,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 672 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $3,834 | Insurance broker name | EDUCATIONAL & INSTL ADM INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL662290 |
Policy instance | 1 |
Insurance contract or identification number | ABL662290 | Number of Individuals Covered | 337 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-11-01 | Total amount of commissions paid to insurance broker | USD $405 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $2,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $405 | Insurance broker organization code? | 3 | Insurance broker name | BRUCE BEATTIE & ASSOCIATES |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 090567 |
Policy instance | 1 |
Insurance contract or identification number | 090567 | Number of Individuals Covered | 270 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $11,612 | Total amount of fees paid to insurance company | USD $581 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $77,511 | 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 | 092157 |
Policy instance | 2 |
Insurance contract or identification number | 092157 | Number of Individuals Covered | 155 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,699 | Total amount of fees paid to insurance company | USD $255 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,981 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 553888 |
Policy instance | 3 |
Insurance contract or identification number | 553888 | Number of Individuals Covered | 126 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $6,312 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 4 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 313 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $49,819 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $996,371 | 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 | 696914G |
Policy instance | 5 |
Insurance contract or identification number | 696914G | Number of Individuals Covered | 268 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,912 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,598 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 553888 |
Policy instance | 4 |
Insurance contract or identification number | 553888 | Number of Individuals Covered | 115 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,286 | 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 | Insurance broker name | |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 092157 |
Policy instance | 3 |
Insurance contract or identification number | 092157 | Number of Individuals Covered | 157 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,692 | Total amount of fees paid to insurance company | USD $254 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,841 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,946 | Insurance broker name | BRUCE BEATTIE AND ASSOCIATES INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 090567 |
Policy instance | 2 |
Insurance contract or identification number | 090567 | Number of Individuals Covered | 254 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $11,278 | Total amount of fees paid to insurance company | USD $564 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $75,610 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,278 | Amount paid for insurance broker fees | 564 | Insurance broker name | BRUCE BEATTIE AND ASSOCIATES INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6307200000 |
Policy instance | 1 |
Insurance contract or identification number | 6307200000 | Number of Individuals Covered | 297 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $41,609 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $832,181 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 41609 | Insurance broker name | BRUCE BEATTIE AND ASSOCIATES |
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