Logo

BEVERLY FARM FOUNDATION GROUP INSURANCE 401k Plan overview

Plan NameBEVERLY FARM FOUNDATION GROUP INSURANCE
Plan identification number 501

BEVERLY FARM FOUNDATION GROUP INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BEVERLY FARM FOUNDATION has sponsored the creation of one or more 401k plans.

Company Name:BEVERLY FARM FOUNDATION
Employer identification number (EIN):370765971
NAIC Classification:624310
NAIC Description:Vocational Rehabilitation Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEVERLY FARM FOUNDATION GROUP INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01
5012021-07-01
5012020-07-01
5012019-07-01
5012018-07-01
5012017-07-01BRENDA MILLER
5012016-07-01BRENDA MILLER
5012015-07-01BRENDA MILLER
5012014-07-01BRENDA MILLER
5012013-07-01BRENDA MILLER
5012012-07-01BRENDA MILLER
5012011-07-01BRENDA MILLER
5012009-07-01BRENDA MILLER

Plan Statistics for BEVERLY FARM FOUNDATION GROUP INSURANCE

401k plan membership statisitcs for BEVERLY FARM FOUNDATION GROUP INSURANCE

Measure Date Value
2022: BEVERLY FARM FOUNDATION GROUP INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-07-01465
Total number of active participants reported on line 7a of the Form 55002022-07-01165
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01165
2021: BEVERLY FARM FOUNDATION GROUP INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-07-01320
Total number of active participants reported on line 7a of the Form 55002021-07-01465
Total of all active and inactive participants2021-07-01465
2020: BEVERLY FARM FOUNDATION GROUP INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-07-01264
Total number of active participants reported on line 7a of the Form 55002020-07-01320
Total of all active and inactive participants2020-07-01320
2019: BEVERLY FARM FOUNDATION GROUP INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-07-01192
Total number of active participants reported on line 7a of the Form 55002019-07-01264
Total of all active and inactive participants2019-07-01264
2018: BEVERLY FARM FOUNDATION GROUP INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-07-01193
Total number of active participants reported on line 7a of the Form 55002018-07-01192
Total of all active and inactive participants2018-07-01192
2017: BEVERLY FARM FOUNDATION GROUP INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-07-01206
Total number of active participants reported on line 7a of the Form 55002017-07-01193
Total of all active and inactive participants2017-07-01193
2016: BEVERLY FARM FOUNDATION GROUP INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-07-01238
Total number of active participants reported on line 7a of the Form 55002016-07-01206
Total of all active and inactive participants2016-07-01206
2015: BEVERLY FARM FOUNDATION GROUP INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-07-01253
Number of retired or separated participants receiving benefits2015-07-01238
Total of all active and inactive participants2015-07-01238
2014: BEVERLY FARM FOUNDATION GROUP INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-07-01260
Total number of active participants reported on line 7a of the Form 55002014-07-01251
Total of all active and inactive participants2014-07-01251
2013: BEVERLY FARM FOUNDATION GROUP INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-07-01281
Total number of active participants reported on line 7a of the Form 55002013-07-01260
Total of all active and inactive participants2013-07-01260
Total participants2013-07-010
2012: BEVERLY FARM FOUNDATION GROUP INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-07-01314
Total number of active participants reported on line 7a of the Form 55002012-07-01281
Total of all active and inactive participants2012-07-01281
Total participants2012-07-010
2011: BEVERLY FARM FOUNDATION GROUP INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-07-01325
Total number of active participants reported on line 7a of the Form 55002011-07-01314
Total of all active and inactive participants2011-07-01314
Total participants2011-07-01314
2009: BEVERLY FARM FOUNDATION GROUP INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-07-01287
Total number of active participants reported on line 7a of the Form 55002009-07-01287
Total of all active and inactive participants2009-07-01287
Total participants2009-07-01287

Form 5500 Responses for BEVERLY FARM FOUNDATION GROUP INSURANCE

2022: BEVERLY FARM FOUNDATION GROUP INSURANCE 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: BEVERLY FARM FOUNDATION GROUP INSURANCE 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: BEVERLY FARM FOUNDATION GROUP INSURANCE 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: BEVERLY FARM FOUNDATION GROUP INSURANCE 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: BEVERLY FARM FOUNDATION GROUP INSURANCE 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: BEVERLY FARM FOUNDATION GROUP INSURANCE 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: BEVERLY FARM FOUNDATION GROUP INSURANCE 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: BEVERLY FARM FOUNDATION GROUP INSURANCE 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: BEVERLY FARM FOUNDATION GROUP INSURANCE 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: BEVERLY FARM FOUNDATION GROUP INSURANCE 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: BEVERLY FARM FOUNDATION GROUP INSURANCE 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: BEVERLY FARM FOUNDATION GROUP INSURANCE 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: BEVERLY FARM FOUNDATION GROUP INSURANCE 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered80
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $3,000
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT VO
Welfare Benefit Premiums Paid to CarrierUSD $20,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered11
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $827
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $827
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered14
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $740
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $740
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 1
Insurance contract or identification numberG000ADT4
Number of Individuals Covered165
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Total amount of commissions paid to insurance brokerUSD $605
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $605
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 1
Insurance contract or identification numberG000ADT4
Number of Individuals Covered465
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $813
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $527
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered11
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $948
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $697
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered16
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $923
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $665
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered84
Insurance policy start date2020-09-01
Insurance policy end date2021-09-01
Total amount of commissions paid to insurance brokerUSD $3,338
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,179
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered21
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $1,341
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,341
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered26
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $1,098
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,098
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 5
Insurance contract or identification numberG000ADT4
Number of Individuals Covered96
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $3,427
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,427
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS566855
Policy instance 1
Insurance contract or identification numberUS566855
Number of Individuals Covered221
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $344,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered320
Insurance policy start date2019-09-01
Insurance policy end date2020-09-01
Total amount of commissions paid to insurance brokerUSD $747
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $747
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 5
Insurance contract or identification numberG000ADT4
Number of Individuals Covered70
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $309
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $15,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees309
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered32
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $166
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees166
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered26
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $208
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees208
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered267
Insurance policy start date2018-09-01
Insurance policy end date2019-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $88
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees88
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS566855
Policy instance 1
Insurance contract or identification numberUS566855
Number of Individuals Covered264
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $469,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS566855
Policy instance 1
Insurance contract or identification numberUS566855
Number of Individuals Covered192
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $359,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered183
Insurance policy start date2017-09-01
Insurance policy end date2018-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $174
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees174
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered25
Insurance policy start date2017-09-01
Insurance policy end date2018-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $508
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees508
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered27
Insurance policy start date2017-09-01
Insurance policy end date2018-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $356
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees356
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered29
Insurance policy start date2016-09-01
Insurance policy end date2017-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $340
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered30
Insurance policy start date2016-09-01
Insurance policy end date2017-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $488
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered193
Insurance policy start date2016-09-01
Insurance policy end date2017-09-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $173
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS566855
Policy instance 1
Insurance contract or identification numberUS566855
Number of Individuals Covered199
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $368,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered35
Insurance policy start date2014-09-01
Insurance policy end date2015-09-01
Total amount of commissions paid to insurance brokerUSD $1,676
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,676
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered32
Insurance policy start date2014-09-01
Insurance policy end date2015-09-01
Total amount of commissions paid to insurance brokerUSD $1,067
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,067
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31327
Policy instance 1
Insurance contract or identification numberHCL31327
Number of Individuals Covered240
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $253,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered238
Insurance policy start date2014-09-01
Insurance policy end date2015-09-01
Total amount of commissions paid to insurance brokerUSD $694
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $694
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered253
Insurance policy start date2013-09-01
Insurance policy end date2014-09-01
Total amount of commissions paid to insurance brokerUSD $703
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $703
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31327
Policy instance 1
Insurance contract or identification numberHCL31327
Number of Individuals Covered253
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $213,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered32
Insurance policy start date2013-09-01
Insurance policy end date2014-09-01
Total amount of commissions paid to insurance brokerUSD $1,174
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,174
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered39
Insurance policy start date2013-09-01
Insurance policy end date2014-09-01
Total amount of commissions paid to insurance brokerUSD $1,909
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,909
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
ALTERNATIVE RISK SOLUTIONS, LLC (National Association of Insurance Commissioners NAIC id number: )
Policy contract number
Policy instance 1
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $242,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered258
Insurance policy start date2012-09-01
Insurance policy end date2013-09-01
Total amount of commissions paid to insurance brokerUSD $735
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $735
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered37
Insurance policy start date2012-09-01
Insurance policy end date2013-09-01
Total amount of commissions paid to insurance brokerUSD $1,882
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,882
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 4
Insurance contract or identification numberG000ADT4
Number of Individuals Covered31
Insurance policy start date2012-09-01
Insurance policy end date2013-09-01
Total amount of fees paid to insurance companyUSD $1,104
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1104
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 1
Insurance contract or identification numberG000ADT4
Number of Individuals Covered30
Insurance policy start date2011-09-01
Insurance policy end date2012-09-01
Total amount of commissions paid to insurance brokerUSD $1,026
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,026
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214334
Policy instance 4
Insurance contract or identification number214334
Number of Individuals Covered281
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 3
Insurance contract or identification numberG000ADT4
Number of Individuals Covered260
Insurance policy start date2011-09-01
Insurance policy end date2012-09-01
Total amount of commissions paid to insurance brokerUSD $728
Life Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $728
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 2
Insurance contract or identification numberG000ADT4
Number of Individuals Covered40
Insurance policy start date2011-09-01
Insurance policy end date2012-09-01
Total amount of commissions paid to insurance brokerUSD $1,868
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,868
Insurance broker organization code?3
Insurance broker nameCLJM, LLC DBA HUNTLEIGH MCGEHEE INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214334
Policy instance 2
Insurance contract or identification number214334
Number of Individuals Covered273
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $3,841
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $236,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 1
Insurance contract or identification numberG000ADT4
Number of Individuals Covered337
Insurance policy start date2010-09-01
Insurance policy end date2011-09-01
Total amount of commissions paid to insurance brokerUSD $757
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number65809-0
Policy instance 2
Insurance contract or identification number65809-0
Number of Individuals Covered287
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ADT4
Policy instance 1
Insurance contract or identification numberG000ADT4
Number of Individuals Covered347
Insurance policy start date2009-09-01
Insurance policy end date2010-09-01
Total amount of commissions paid to insurance brokerUSD $3,686
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADDITIONAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $24,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S1