CHARLES GABUS FORD, INC. has sponsored the creation of one or more 401k plans.
Additional information about CHARLES GABUS FORD, INC.
Measure | Date | Value |
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2022: THE HEALTH CARE CHOICE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 277 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 292 |
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 | 292 |
2021: THE HEALTH CARE CHOICE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 358 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 277 |
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 | 277 |
2020: THE HEALTH CARE CHOICE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 358 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 358 |
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 | 358 |
2019: THE HEALTH CARE CHOICE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 274 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 272 |
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 | 272 |
2018: THE HEALTH CARE CHOICE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 274 |
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 | 274 |
2017: THE HEALTH CARE CHOICE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 245 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 261 |
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 | 261 |
2016: THE HEALTH CARE CHOICE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 323 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 245 |
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 | 245 |
2015: THE HEALTH CARE CHOICE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 316 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 323 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 323 |
2014: THE HEALTH CARE CHOICE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 302 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 316 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 316 |
2013: THE HEALTH CARE CHOICE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 418 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 302 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 302 |
2012: THE HEALTH CARE CHOICE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 401 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 418 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 418 |
2011: THE HEALTH CARE CHOICE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 389 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 401 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 401 |
2009: THE HEALTH CARE CHOICE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 374 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 398 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 398 |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 7 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 95 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $4,962 | Total amount of fees paid to insurance company | USD $1,104 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $49,621 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,962 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1104 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 2 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 258 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $4,092 | Total amount of fees paid to insurance company | USD $2,848 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,838 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,092 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2848 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 910874 |
Policy instance | 1 |
Insurance contract or identification number | 910874 | Number of Individuals Covered | 443 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,042 | Total amount of fees paid to insurance company | USD $33,240 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,912,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,042 | Amount paid for insurance broker fees | 33240 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 3 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 258 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $491 | Total amount of fees paid to insurance company | USD $304 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) AD&D | Welfare Benefit Premiums Paid to Carrier | USD $4,913 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $491 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 304 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 4 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 116 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $4,476 | Total amount of fees paid to insurance company | USD $3,988 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,044 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,476 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3988 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 5 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 153 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,260 | Total amount of fees paid to insurance company | USD $4,497 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) AD&D | Welfare Benefit Premiums Paid to Carrier | USD $82,666 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,260 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 4497 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 6 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 95 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,062 | Total amount of fees paid to insurance company | USD $412 | Other welfare benefits provided | ACCIDENT ONLY VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $20,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,062 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 412 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 2 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 278 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,554 | Total amount of fees paid to insurance company | USD $1,740 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,371 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,554 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1740 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 910874 |
Policy instance | 1 |
Insurance contract or identification number | 910874 | Number of Individuals Covered | 487 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,610 | Total amount of fees paid to insurance company | USD $40,775 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,075,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,610 | Amount paid for insurance broker fees | 40775 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 3 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 278 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $531 | Total amount of fees paid to insurance company | USD $197 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $531 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 197 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 4 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 109 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,667 | Total amount of fees paid to insurance company | USD $2,453 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $76,687 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,667 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2453 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BTCW |
Policy instance | 5 |
Insurance contract or identification number | G000BTCW | Number of Individuals Covered | 166 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $8,232 | Total amount of fees paid to insurance company | USD $2,852 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) AD&D | Welfare Benefit Premiums Paid to Carrier | USD $82,204 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,232 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2852 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 1 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 251 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,127 | Total amount of fees paid to insurance company | USD $1,143 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,963 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,127 | Amount paid for insurance broker fees | 1143 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 910874 |
Policy instance | 2 |
Insurance contract or identification number | 910874 | Number of Individuals Covered | 498 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,809 | Total amount of fees paid to insurance company | USD $43,322 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,091,860 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,809 | Amount paid for insurance broker fees | 43322 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5954926 |
Policy instance | 3 |
Insurance contract or identification number | 5954926 | Number of Individuals Covered | 418 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $28,770 | Total amount of fees paid to insurance company | USD $8,227 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) ADD | Welfare Benefit Premiums Paid to Carrier | USD $177,753 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,754 | Amount paid for insurance broker fees | 41 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 910874 |
Policy instance | 2 |
Insurance contract or identification number | 910874 | Number of Individuals Covered | 495 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,788 | Total amount of fees paid to insurance company | USD $40,335 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,986,484 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,788 | Amount paid for insurance broker fees | 40335 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 1 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 285 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $4,509 | Total amount of fees paid to insurance company | USD $364 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,509 | Amount paid for insurance broker fees | 364 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5954926 |
Policy instance | 3 |
Insurance contract or identification number | 5954926 | Number of Individuals Covered | 432 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $24,577 | Total amount of fees paid to insurance company | USD $6,939 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OTHER (SPECIFY) ADD | Welfare Benefit Premiums Paid to Carrier | USD $194,522 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,335 | Amount paid for insurance broker fees | 54 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 4 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 364 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $5,478 | 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) | Welfare Benefit Premiums Paid to Carrier | USD $27,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,478 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 2 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 260 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $5,185 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,833 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,758 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 1 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 392 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Total amount of commissions paid to insurance broker | USD $13,944 | 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) | Welfare Benefit Premiums Paid to Carrier | USD $69,719 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,944 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 910874 |
Policy instance | 3 |
Insurance contract or identification number | 910874 | Number of Individuals Covered | 454 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $3,209 | Total amount of fees paid to insurance company | USD $43,020 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,978,884 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,209 | Amount paid for insurance broker fees | 43020 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 1 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 446 | Insurance policy start date | 2016-08-01 | Insurance policy end date | 2017-07-31 | Total amount of commissions paid to insurance broker | USD $13,726 | 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) | Welfare Benefit Premiums Paid to Carrier | USD $68,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,726 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 2 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 253 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $3,993 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,853 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,993 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0284074 |
Policy instance | 3 |
Insurance contract or identification number | 0284074 | Number of Individuals Covered | 7 | Insurance policy start date | 2016-02-01 | Insurance policy end date | 2017-01-31 | Total amount of commissions paid to insurance broker | USD $626 | Total amount of fees paid to insurance company | USD $113 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $626 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 113 | Additional information about fees paid to insurance broker | OTHER COMPENSATION INDIRECTLY RELATED TO PREMIUMS PAID | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 4 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 257 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $3,597 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,597 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 6 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $413 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,512 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $413 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 2 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 446 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $24,368 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,341,493 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,368 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 1 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 419 | Insurance policy start date | 2014-08-01 | Insurance policy end date | 2015-07-31 | Total amount of commissions paid to insurance broker | USD $13,823 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,107 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,823 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 4 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 256 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $3,659 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,854 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,659 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
|
COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 2 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 493 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $29,520 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,475,995 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,520 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 1 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 447 | Insurance policy start date | 2013-08-01 | Insurance policy end date | 2014-07-31 | Total amount of commissions paid to insurance broker | USD $13,909 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,909 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 6 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $453 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $453 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-21023 |
Policy instance | 1 |
Insurance contract or identification number | 010-21023 | Number of Individuals Covered | 547 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $1,676 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,443 | 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 | BLAKELY INSURANCE INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 5 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 293 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $3,756 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,756 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 2 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 454 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $13,188 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65,939 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,188 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 4 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 6 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $393 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,988 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $393 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 599 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $30,939 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,586,816 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,939 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 2 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 455 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $13,310 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,310 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 5 |
Insurance contract or identification number | LTD 118631 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Insurance broker name | BLAKELY INSURANCE INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 4 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 4 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $206 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $206 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 628 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $31,416 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,570,791 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,416 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-21023 |
Policy instance | 1 |
Insurance contract or identification number | 010-21023 | Number of Individuals Covered | 563 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $3,785 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $147,169 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,785 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-21023 |
Policy instance | 1 |
Insurance contract or identification number | 010-21023 | Number of Individuals Covered | 547 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-11-30 | Total amount of commissions paid to insurance broker | USD $3,716 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $141,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 5 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 310 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $3,984 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 585 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $30,045 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,724,432 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 4 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 1 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 2 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 456 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $12,074 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,369 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-21023 |
Policy instance | 1 |
Insurance contract or identification number | 010-21023 | Number of Individuals Covered | 530 | Insurance policy start date | 2009-12-01 | Insurance policy end date | 2010-11-30 | Total amount of commissions paid to insurance broker | USD $3,732 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $142,913 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,732 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 118631 |
Policy instance | 5 |
Insurance contract or identification number | LTD 118631 | Number of Individuals Covered | 297 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $4,164 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,239 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,164 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 7026060000 |
Policy instance | 4 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 1 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $55 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $55 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 689114G |
Policy instance | 2 |
Insurance contract or identification number | 689114G | Number of Individuals Covered | 440 | Insurance policy start date | 2009-08-01 | Insurance policy end date | 2010-07-31 | Total amount of commissions paid to insurance broker | USD $12,394 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,394 | Insurance broker organization code? | 3 | Insurance broker name | BLAKELY INSURANCE INC |
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COVENTRY HEALTH CARE OF IOWA (National Association of Insurance Commissioners NAIC id number: 95241 ) |
Policy contract number | 7026060000 |
Policy instance | 3 |
Insurance contract or identification number | 7026060000 | Number of Individuals Covered | 594 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $29,778 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,488,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,778 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC |
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