BROWNELLS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BROWNELLS INC HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023: BROWNELLS INC HEALTH AND WELFARE PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 481 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 512 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 512 |
| 2022: BROWNELLS INC HEALTH AND WELFARE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 527 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 481 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 481 |
| 2021: BROWNELLS INC HEALTH AND WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 521 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 527 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 527 |
| 2020: BROWNELLS INC HEALTH AND WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 573 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 521 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 521 |
| 2019: BROWNELLS INC HEALTH AND WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 613 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 573 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 573 |
| 2018: BROWNELLS INC HEALTH AND WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 276 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 613 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 613 |
| 2017: BROWNELLS INC HEALTH AND WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 360 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 276 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 276 |
| 2016: BROWNELLS INC HEALTH AND WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 348 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 360 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| 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 | 360 |
| 2015: BROWNELLS INC HEALTH AND WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 273 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 348 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 7 |
| 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 | 355 |
| 2014: BROWNELLS INC HEALTH AND WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 273 |
| Total of all active and inactive participants | 2014-01-01 | 273 |
| Total participants | 2014-01-01 | 0 |
| 2013: BROWNELLS INC HEALTH AND WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 296 |
| Total of all active and inactive participants | 2013-01-01 | 296 |
| Total participants | 2013-01-01 | 0 |
| 2012: BROWNELLS INC HEALTH AND WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 227 |
| Total of all active and inactive participants | 2012-01-01 | 227 |
| Total participants | 2012-01-01 | 0 |
| 2011: BROWNELLS INC HEALTH AND WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 176 |
| Total of all active and inactive participants | 2011-01-01 | 176 |
| Total participants | 2011-01-01 | 176 |
| 2009: BROWNELLS INC HEALTH AND WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 144 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 133 |
| Total of all active and inactive participants | 2009-01-01 | 133 |
| Total participants | 2009-01-01 | 133 |
| 2023: BROWNELLS INC HEALTH AND WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: BROWNELLS INC HEALTH AND WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: BROWNELLS INC HEALTH AND WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: BROWNELLS INC HEALTH AND WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: BROWNELLS INC HEALTH AND WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: BROWNELLS INC HEALTH AND WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: BROWNELLS INC HEALTH AND WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: BROWNELLS INC HEALTH AND WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan 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: BROWNELLS INC HEALTH AND WELFARE PLAN 2015 form 5500 responses |
|---|
| 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: BROWNELLS INC HEALTH AND WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BROWNELLS INC HEALTH AND WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BROWNELLS INC HEALTH AND WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BROWNELLS INC HEALTH AND WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BROWNELLS INC HEALTH AND WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248678 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248678 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $2,320 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 15888 ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 512 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $69,581 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $969,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248680 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248680 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $4,195 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $45,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248681 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248681 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $2,436 | | Other welfare benefits provided | OTHER (WEEKLY INCOME) | | Welfare Benefit Premiums Paid to Carrier | USD $24,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000403007210 |
| Policy instance | 5 |
| Insurance contract or identification number | 000403007210 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $456 | | Other welfare benefits provided | OTHER (VOL AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $4,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000400001000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $3,600 | | Other welfare benefits provided | OTHER (VOL LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $39,680 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30069840 |
| Policy instance | 7 |
| Insurance contract or identification number | 30069840 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,247 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN PUBLIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60801 ) |
| Policy contract number | GAO21H |
| Policy instance | 8 |
| Insurance contract or identification number | GAO21H | | Number of Individuals Covered | 246 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $11,481 | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $44,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN PUBLIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60801 ) |
| Policy contract number | GCI21H |
| Policy instance | 9 |
| Insurance contract or identification number | GCI21H | | Number of Individuals Covered | 241 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $13,895 | | Other welfare benefits provided | OTHER (CRITICAL ILLNESS) | | Welfare Benefit Premiums Paid to Carrier | USD $50,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN PUBLIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60801 ) |
| Policy contract number | HI17HP |
| Policy instance | 10 |
| Insurance contract or identification number | HI17HP | | Number of Individuals Covered | 245 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of fees paid to insurance company | USD $11,505 | | Welfare Benefit Premiums Paid to Carrier | USD $47,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248680 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248680 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $3,064 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $45,960 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3064 | | Additional information about fees paid to insurance broker | OVERRIDES BROKER BONUS | | Insurance broker organization code? | 3 |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 15888 ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 481 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $57,814 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,052,774 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 57814 | | Additional information about fees paid to insurance broker | BROKER SERVICE FEES | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30069840 |
| Policy instance | 7 |
| Insurance contract or identification number | 30069840 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,324 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248678 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248678 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $1,468 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,240 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1468 | | Additional information about fees paid to insurance broker | OVERRIDES BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248681 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248681 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $2,087 | | Other welfare benefits provided | OTHER (WEEKLY INCOME) | | Welfare Benefit Premiums Paid to Carrier | USD $28,447 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2087 | | Additional information about fees paid to insurance broker | OVERRIDES BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000403007210 |
| Policy instance | 5 |
| Insurance contract or identification number | 000403007210 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $334 | | Other welfare benefits provided | OTHER (VOL AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $5,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 334 | | Additional information about fees paid to insurance broker | OVERRIDES BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000400001000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 151 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of fees paid to insurance company | USD $2,626 | | Other welfare benefits provided | OTHER (VOL LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $38,951 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2626 | | Additional information about fees paid to insurance broker | OVERRIDES BROKER BONUS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5121637 |
| Policy instance | 7 |
| Insurance contract or identification number | E5121637 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,079 | | Total amount of fees paid to insurance company | USD $36 | | Other welfare benefits provided | OTHER (WHOLE LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $8,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $511 | | Amount paid for insurance broker fees | 7 | | Additional information about fees paid to insurance broker | INSURANCE FEES AND COMMISSIONS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000400001000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $1,396 | | Other welfare benefits provided | OTHER (VOL LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $39,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 787 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000403007210 |
| Policy instance | 5 |
| Insurance contract or identification number | 000403007210 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $79 | | Other welfare benefits provided | OTHER (VOL AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $4,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 70 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248681 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248681 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $1,286 | | Other welfare benefits provided | OTHER (WEEKLY INCOME) | | Welfare Benefit Premiums Paid to Carrier | USD $31,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 623 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248678 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248678 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $729 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,623 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 392 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248680 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248680 | | Number of Individuals Covered | 336 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $1,659 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $43,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 864 | | Additional information about fees paid to insurance broker | CONSULTING | | Insurance broker organization code? | 3 |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 15888 ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $63,520 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $909,983 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 63520 | | Additional information about fees paid to insurance broker | BROKER SERVICE FEES | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30069840 |
| Policy instance | 8 |
| Insurance contract or identification number | 30069840 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,721 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 15888 ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 521 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $81,574 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $791,373 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 81574 | | Additional information about fees paid to insurance broker | BROKER SERVICE FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248680 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248680 | | Number of Individuals Covered | 333 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $803 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $40,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 803 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248678 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248678 | | Number of Individuals Covered | 101 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $334 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,716 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 334 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248681 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248681 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $687 | | Other welfare benefits provided | OTHER (WEEKLY INCOME) | | Welfare Benefit Premiums Paid to Carrier | USD $34,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 687 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000403007210 |
| Policy instance | 5 |
| Insurance contract or identification number | 000403007210 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | OTHER (VOL AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $4,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000400001000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of fees paid to insurance company | USD $614 | | Other welfare benefits provided | OTHER (VOL LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $30,676 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 614 | | Additional information about fees paid to insurance broker | OVERRIDES | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5121637 |
| Policy instance | 7 |
| Insurance contract or identification number | E5121637 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $9,316 | | Total amount of fees paid to insurance company | USD $839 | | Other welfare benefits provided | OTHER (WHOLE LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $31,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,365 | | Additional information about fees paid to insurance broker | INSURANCE FEES AND COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 392 |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 573 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $94,189 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $785,537 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 94189 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248680 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010248680 | | Number of Individuals Covered | 346 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $2,373 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $45,659 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1460 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248681 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010248681 | | Number of Individuals Covered | 185 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $1,960 | | Other welfare benefits provided | OTHER (WEEKLY INCOME) | | Welfare Benefit Premiums Paid to Carrier | USD $37,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1207 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000403007210 |
| Policy instance | 5 |
| Insurance contract or identification number | 000403007210 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $131 | | Other welfare benefits provided | OTHER (VOL AD&D) | | Welfare Benefit Premiums Paid to Carrier | USD $4,166 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 131 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000400001000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000400001000 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $1,785 | | Other welfare benefits provided | OTHER (VOL LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $35,078 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1083 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E5121637 |
| Policy instance | 7 |
| Insurance contract or identification number | E5121637 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $18,894 | | Total amount of fees paid to insurance company | USD $1,820 | | Other welfare benefits provided | OTHER (WHOLE LIFE) | | Welfare Benefit Premiums Paid to Carrier | USD $34,710 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,366 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 717 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
| Policy contract number | 000010248678 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010248678 | | Number of Individuals Covered | 102 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $951 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 589 | | Additional information about fees paid to insurance broker | BROKER BOUNS | | Insurance broker organization code? | 3 |
|
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 32850 |
| Policy instance | 1 |
| Insurance contract or identification number | 32850 | | Number of Individuals Covered | 613 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $97,146 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $809,696 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 97146 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 246165 |
| Policy instance | 3 |
| Insurance contract or identification number | 246165 | | Number of Individuals Covered | 405 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | 00023301 |
| Policy instance | 2 |
| Insurance contract or identification number | 00023301 | | Number of Individuals Covered | 412 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $12,059 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $40,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,297 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) |
| Policy contract number | 32403 |
| Policy instance | 2 |
| Insurance contract or identification number | 32403 | | Number of Individuals Covered | 276 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $4,481 | | Total amount of fees paid to insurance company | USD $148 | | Dental 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 $4,481 | | Amount paid for insurance broker fees | 148 | | Additional information about fees paid to insurance broker | SALES AND PERSISTENCY BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH & BENEFITS |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 246165 |
| Policy instance | 4 |
| Insurance contract or identification number | 246165 | | Number of Individuals Covered | 348 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (AD&D) | | 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 | BERNIE LOWE & ASSOCIATES INC |
|
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 246 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,421 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $8,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,421 | | Insurance broker name | MERCER HEALTH & BENEFITS |
|
