BEVERLY FARM FOUNDATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BEVERLY FARM FOUNDATION GROUP INSURANCE
Measure | Date | Value |
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2022: BEVERLY FARM FOUNDATION GROUP INSURANCE 2022 401k membership |
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Total participants, beginning-of-year | 2022-07-01 | 465 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 165 |
Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
Total of all active and inactive participants | 2022-07-01 | 165 |
2021: BEVERLY FARM FOUNDATION GROUP INSURANCE 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 320 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 465 |
Total of all active and inactive participants | 2021-07-01 | 465 |
2020: BEVERLY FARM FOUNDATION GROUP INSURANCE 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 264 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 320 |
Total of all active and inactive participants | 2020-07-01 | 320 |
2019: BEVERLY FARM FOUNDATION GROUP INSURANCE 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 192 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 264 |
Total of all active and inactive participants | 2019-07-01 | 264 |
2018: BEVERLY FARM FOUNDATION GROUP INSURANCE 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 193 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 192 |
Total of all active and inactive participants | 2018-07-01 | 192 |
2017: BEVERLY FARM FOUNDATION GROUP INSURANCE 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 206 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 193 |
Total of all active and inactive participants | 2017-07-01 | 193 |
2016: BEVERLY FARM FOUNDATION GROUP INSURANCE 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 238 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 206 |
Total of all active and inactive participants | 2016-07-01 | 206 |
2015: BEVERLY FARM FOUNDATION GROUP INSURANCE 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 253 |
Number of retired or separated participants receiving benefits | 2015-07-01 | 238 |
Total of all active and inactive participants | 2015-07-01 | 238 |
2014: BEVERLY FARM FOUNDATION GROUP INSURANCE 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 260 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 251 |
Total of all active and inactive participants | 2014-07-01 | 251 |
2013: BEVERLY FARM FOUNDATION GROUP INSURANCE 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 281 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 260 |
Total of all active and inactive participants | 2013-07-01 | 260 |
Total participants | 2013-07-01 | 0 |
2012: BEVERLY FARM FOUNDATION GROUP INSURANCE 2012 401k membership |
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Total participants, beginning-of-year | 2012-07-01 | 314 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 281 |
Total of all active and inactive participants | 2012-07-01 | 281 |
Total participants | 2012-07-01 | 0 |
2011: BEVERLY FARM FOUNDATION GROUP INSURANCE 2011 401k membership |
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Total participants, beginning-of-year | 2011-07-01 | 325 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 314 |
Total of all active and inactive participants | 2011-07-01 | 314 |
Total participants | 2011-07-01 | 314 |
2009: BEVERLY FARM FOUNDATION GROUP INSURANCE 2009 401k membership |
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Total participants, beginning-of-year | 2009-07-01 | 287 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 287 |
Total of all active and inactive participants | 2009-07-01 | 287 |
Total participants | 2009-07-01 | 287 |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 80 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $3,000 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT VO | Welfare Benefit Premiums Paid to Carrier | USD $20,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,000 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 11 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $827 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,515 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $827 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 14 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $740 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,933 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $740 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 1 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 165 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-09-01 | Total amount of commissions paid to insurance broker | USD $605 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,032 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $605 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 1 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 465 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $813 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $5,420 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $527 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 11 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $948 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $697 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 16 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $923 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,149 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $665 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 84 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-09-01 | Total amount of commissions paid to insurance broker | USD $3,338 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,179 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 21 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-09-01 | Total amount of commissions paid to insurance broker | USD $1,341 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,937 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,341 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 26 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-09-01 | Total amount of commissions paid to insurance broker | USD $1,098 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,319 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,098 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 5 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 96 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-09-01 | Total amount of commissions paid to insurance broker | USD $3,427 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,847 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,427 | Insurance broker organization code? | 3 |
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US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
Policy contract number | US566855 |
Policy instance | 1 |
Insurance contract or identification number | US566855 | Number of Individuals Covered | 221 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $344,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 320 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-09-01 | Total amount of commissions paid to insurance broker | USD $747 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,980 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $747 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 5 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 70 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $309 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 309 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 32 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $166 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 166 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 26 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $208 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 208 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 267 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $88 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 88 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
Policy contract number | US566855 |
Policy instance | 1 |
Insurance contract or identification number | US566855 | Number of Individuals Covered | 264 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $469,827 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
Policy contract number | US566855 |
Policy instance | 1 |
Insurance contract or identification number | US566855 | Number of Individuals Covered | 192 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $359,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 183 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $174 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 174 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 25 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $508 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 508 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 27 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $356 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 356 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 29 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $340 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,951 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 30 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $488 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,050 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 193 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-09-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $173 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $3,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
Policy contract number | US566855 |
Policy instance | 1 |
Insurance contract or identification number | US566855 | Number of Individuals Covered | 199 | Insurance policy start date | 2016-09-01 | Insurance policy end date | 2017-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $368,920 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 35 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $1,676 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,175 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,676 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 32 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $1,067 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,067 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL31327 |
Policy instance | 1 |
Insurance contract or identification number | HCL31327 | Number of Individuals Covered | 240 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $253,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 238 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $694 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $694 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 253 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $703 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,684 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $703 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL31327 |
Policy instance | 1 |
Insurance contract or identification number | HCL31327 | Number of Individuals Covered | 253 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $213,109 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 32 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $1,174 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,174 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 39 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $1,909 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,725 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,909 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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ALTERNATIVE RISK SOLUTIONS, LLC (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | |
Policy instance | 1 |
Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $242,492 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 258 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-09-01 | Total amount of commissions paid to insurance broker | USD $735 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,899 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $735 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 37 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-09-01 | Total amount of commissions paid to insurance broker | USD $1,882 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,544 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,882 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 4 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 31 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-09-01 | Total amount of fees paid to insurance company | USD $1,104 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $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 fees | 1104 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 1 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 30 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $1,026 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,840 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,026 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214334 |
Policy instance | 4 |
Insurance contract or identification number | 214334 | Number of Individuals Covered | 281 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $253,743 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 3 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $728 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $4,852 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $728 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 2 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 40 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $1,868 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,456 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,868 | Insurance broker organization code? | 3 | Insurance broker name | CLJM, LLC DBA HUNTLEIGH MCGEHEE INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 214334 |
Policy instance | 2 |
Insurance contract or identification number | 214334 | Number of Individuals Covered | 273 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $3,841 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $236,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 1 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 337 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-09-01 | Total amount of commissions paid to insurance broker | USD $757 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $23,604 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 65809-0 |
Policy instance | 2 |
Insurance contract or identification number | 65809-0 | Number of Individuals Covered | 287 | Insurance policy start date | 2009-09-01 | Insurance policy end date | 2010-08-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $238,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ADT4 |
Policy instance | 1 |
Insurance contract or identification number | G000ADT4 | Number of Individuals Covered | 347 | Insurance policy start date | 2009-09-01 | Insurance policy end date | 2010-09-01 | Total amount of commissions paid to insurance broker | USD $3,686 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADDITIONAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,569 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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