PGA TOUR, INC. has sponsored the creation of one or more 401k plans.
Additional information about PGA TOUR, INC.
| Measure | Date | Value |
|---|
| 2022: PGA TOUR INC., WELFARE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 2,798 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 3,213 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 40 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 194 |
| Total of all active and inactive participants | 2022-01-01 | 3,447 |
| Total participants | 2022-01-01 | 3,447 |
| 2021: PGA TOUR INC., WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2,407 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 2,451 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 32 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 172 |
| Total of all active and inactive participants | 2021-01-01 | 2,655 |
| Total participants | 2021-01-01 | 2,655 |
| 2020: PGA TOUR INC., WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 2,656 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 2,449 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 51 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 168 |
| Total of all active and inactive participants | 2020-01-01 | 2,668 |
| Total participants | 2020-01-01 | 2,668 |
| 2019: PGA TOUR INC., WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 2,358 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 2,479 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 37 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 158 |
| Total of all active and inactive participants | 2019-01-01 | 2,674 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Total participants | 2019-01-01 | 2,674 |
| Number of participants with account balances | 2019-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: PGA TOUR INC., WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-01 | 2,615 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 2,761 |
| Number of retired or separated participants receiving benefits | 2018-11-01 | 35 |
| Number of other retired or separated participants entitled to future benefits | 2018-11-01 | 211 |
| Total of all active and inactive participants | 2018-11-01 | 3,007 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-11-01 | 0 |
| Total participants | 2018-11-01 | 3,007 |
| Number of participants with account balances | 2018-11-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-11-01 | 0 |
| Number of employers contributing to the scheme | 2018-11-01 | 0 |
| 2017: PGA TOUR INC., WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-01 | 2,641 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 2,666 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 44 |
| Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 151 |
| Total of all active and inactive participants | 2017-11-01 | 2,861 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-11-01 | 1 |
| Total participants | 2017-11-01 | 2,862 |
| Number of participants with account balances | 2017-11-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2017-11-01 | 0 |
| 2016: PGA TOUR INC., WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-01 | 2,444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 2,679 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 40 |
| Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 74 |
| Total of all active and inactive participants | 2016-11-01 | 2,793 |
| Total participants | 2016-11-01 | 2,793 |
| 2015: PGA TOUR INC., WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-01 | 2,395 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 2,568 |
| Number of retired or separated participants receiving benefits | 2015-11-01 | 24 |
| Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 44 |
| Total of all active and inactive participants | 2015-11-01 | 2,636 |
| Total participants | 2015-11-01 | 2,636 |
| 2014: PGA TOUR INC., WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-01 | 2,312 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 2,477 |
| Number of retired or separated participants receiving benefits | 2014-11-01 | 30 |
| Number of other retired or separated participants entitled to future benefits | 2014-11-01 | 85 |
| Total of all active and inactive participants | 2014-11-01 | 2,592 |
| Total participants | 2014-11-01 | 2,592 |
| 2013: PGA TOUR INC., WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-01 | 2,383 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 2,412 |
| Number of retired or separated participants receiving benefits | 2013-11-01 | 25 |
| Number of other retired or separated participants entitled to future benefits | 2013-11-01 | 55 |
| Total of all active and inactive participants | 2013-11-01 | 2,492 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-11-01 | 1 |
| Total participants | 2013-11-01 | 2,493 |
| 2012: PGA TOUR INC., WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-01 | 2,274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 2,407 |
| Number of retired or separated participants receiving benefits | 2012-11-01 | 28 |
| Number of other retired or separated participants entitled to future benefits | 2012-11-01 | 34 |
| Total of all active and inactive participants | 2012-11-01 | 2,469 |
| Total participants | 2012-11-01 | 2,469 |
| 2011: PGA TOUR INC., WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-01 | 2,213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 2,318 |
| Number of retired or separated participants receiving benefits | 2011-11-01 | 32 |
| Number of other retired or separated participants entitled to future benefits | 2011-11-01 | 59 |
| Total of all active and inactive participants | 2011-11-01 | 2,409 |
| Total participants | 2011-11-01 | 2,409 |
| 2010: PGA TOUR INC., WELFARE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-11-01 | 2,250 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-11-01 | 2,293 |
| Number of retired or separated participants receiving benefits | 2010-11-01 | 35 |
| Number of other retired or separated participants entitled to future benefits | 2010-11-01 | 42 |
| Total of all active and inactive participants | 2010-11-01 | 2,370 |
| Total participants | 2010-11-01 | 2,370 |
| 2009: PGA TOUR INC., WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-01 | 2,226 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 2,334 |
| Number of retired or separated participants receiving benefits | 2009-11-01 | 40 |
| Number of other retired or separated participants entitled to future benefits | 2009-11-01 | 61 |
| Total of all active and inactive participants | 2009-11-01 | 2,435 |
| Total participants | 2009-11-01 | 2,435 |
| Number of employers contributing to the scheme | 2009-11-01 | 0 |
| 2022: PGA TOUR INC., WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan is a collectively bargained plan | Yes |
| 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: PGA TOUR INC., WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan is a collectively bargained plan | Yes |
| 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: PGA TOUR INC., WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan is a collectively bargained plan | Yes |
| 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: PGA TOUR INC., WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | Yes |
| 2019-01-01 | Plan is a collectively bargained plan | Yes |
| 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: PGA TOUR INC., WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-11-01 | Plan is a collectively bargained plan | Yes |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: PGA TOUR INC., WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Plan is a collectively bargained plan | Yes |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: PGA TOUR INC., WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | Plan is a collectively bargained plan | Yes |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: PGA TOUR INC., WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | Plan is a collectively bargained plan | Yes |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: PGA TOUR INC., WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-11-01 | Type of plan entity | Single employer plan |
| 2014-11-01 | Plan is a collectively bargained plan | Yes |
| 2014-11-01 | Plan funding arrangement – Insurance | Yes |
| 2014-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: PGA TOUR INC., WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-11-01 | Type of plan entity | Single employer plan |
| 2013-11-01 | Submission has been amended | Yes |
| 2013-11-01 | Plan is a collectively bargained plan | Yes |
| 2013-11-01 | Plan funding arrangement – Insurance | Yes |
| 2013-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: PGA TOUR INC., WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-11-01 | Type of plan entity | Single employer plan |
| 2012-11-01 | Plan is a collectively bargained plan | Yes |
| 2012-11-01 | Plan funding arrangement – Insurance | Yes |
| 2012-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: PGA TOUR INC., WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-11-01 | Type of plan entity | Single employer plan |
| 2011-11-01 | Plan is a collectively bargained plan | Yes |
| 2011-11-01 | Plan funding arrangement – Insurance | Yes |
| 2011-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: PGA TOUR INC., WELFARE PLAN 2010 form 5500 responses |
|---|
| 2010-11-01 | Type of plan entity | Single employer plan |
| 2010-11-01 | Plan is a collectively bargained plan | Yes |
| 2010-11-01 | Plan funding arrangement – Insurance | Yes |
| 2010-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: PGA TOUR INC., WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-11-01 | Type of plan entity | Single employer plan |
| 2009-11-01 | Plan is a collectively bargained plan | Yes |
| 2009-11-01 | Plan funding arrangement – Insurance | Yes |
| 2009-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $16,320 | | Welfare Benefit Premiums Paid to Carrier | USD $500,973 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,320 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000019286 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000019286 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,512 | | Other welfare benefits provided | AFLAC HOSPITAL,CANCER,ACCIDENT,CRIT | | Welfare Benefit Premiums Paid to Carrier | USD $31,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $191 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1694 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2023-01-01 | | Total amount of commissions paid to insurance broker | USD $63,720 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,232 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1903 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,253 | | Other welfare benefits provided | AD&D AND BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $171,177 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,253 | | Additional information about fees paid to insurance broker | SERVICES | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 2057 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $58,575 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,198 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,757 | | Other welfare benefits provided | AFLAC HOSPITAL, ACCIDENT, CANCER AN | | 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 | | Commission paid to Insurance Broker | USD $7 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1325 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $17,339 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $241,645 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,339 | | Additional information about fees paid to insurance broker | COMMISSION PAID | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1993 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $46,203 | | Total amount of fees paid to insurance company | USD $4,672 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $349,797 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,837 | | Amount paid for insurance broker fees | 4513 | | Additional information about fees paid to insurance broker | LIFE SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $8,146 | | Total amount of fees paid to insurance company | USD $1,399 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $134,304 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,146 | | Amount paid for insurance broker fees | 13 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 45085 |
| Policy instance | 10 |
| Insurance contract or identification number | 45085 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $21,166 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0903059 |
| Policy instance | 11 |
| Insurance contract or identification number | 0903059 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $1,569 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,569 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 |
|
| HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9901459 |
| Policy instance | 12 |
| Insurance contract or identification number | 9901459 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,568 | | Total amount of fees paid to insurance company | USD $381 | | Other welfare benefits provided | PRE PAID LEGAL PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $26,250 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,568 | | Additional information about fees paid to insurance broker | COMMISSIONS PAID | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 238 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 926522 |
| Policy instance | 13 |
| Insurance contract or identification number | 926522 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,076 | | Total amount of fees paid to insurance company | USD $39,492 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $720,178 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,061 | | Amount paid for insurance broker fees | 31789 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $14,772 | | Total amount of fees paid to insurance company | USD $49 | | Welfare Benefit Premiums Paid to Carrier | USD $366,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,772 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 49 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1823 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $19,624 | | Other welfare benefits provided | AD&D BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $150,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,624 | | Additional information about fees paid to insurance broker | SERVICES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1534 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2022-01-01 | | Total amount of commissions paid to insurance broker | USD $55,431 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $749,156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,431 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000019286 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000019286 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,232 | | Other welfare benefits provided | HOSPITAL, CANCER, ACCIDENT, CRITICA | | Welfare Benefit Premiums Paid to Carrier | USD $34,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14 | | Additional information about fees paid to insurance broker | EARNED COMMISSION AMOUNT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0903059 |
| Policy instance | 11 |
| Insurance contract or identification number | 0903059 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $289 | | Welfare Benefit Premiums Paid to Carrier | USD $41,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $289 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 1802 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $50,504 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,504 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,023 | | Total amount of fees paid to insurance company | USD $120 | | Other welfare benefits provided | AFLAC HOSPITAL, ACCIDENT, CANCER AN | | Welfare Benefit Premiums Paid to Carrier | USD $50,791 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,186 | | Amount paid for insurance broker fees | 33 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1250 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $17,328 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $226,122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,328 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1815 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $45,553 | | Total amount of fees paid to insurance company | USD $5,754 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $330,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,553 | | Amount paid for insurance broker fees | 5754 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $8,309 | | Total amount of fees paid to insurance company | USD $1,896 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,309 | | Amount paid for insurance broker fees | 21 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 45085 |
| Policy instance | 10 |
| Insurance contract or identification number | 45085 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $13,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9901459 |
| Policy instance | 12 |
| Insurance contract or identification number | 9901459 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,428 | | Total amount of fees paid to insurance company | USD $342 | | Other welfare benefits provided | PRE PAID LEGAL PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $25,529 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,428 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 57 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1225 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $17,953 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $231,433 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,953 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1989 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $30,201 | | Total amount of fees paid to insurance company | USD $3,495 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $316,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,201 | | Amount paid for insurance broker fees | 3495 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $9,038 | | Total amount of fees paid to insurance company | USD $1,844 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $141,869 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,038 | | Amount paid for insurance broker fees | 12 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 45085 |
| Policy instance | 10 |
| Insurance contract or identification number | 45085 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $13,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0903059 |
| Policy instance | 11 |
| Insurance contract or identification number | 0903059 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,200 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $87,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,200 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,553 | | Total amount of fees paid to insurance company | USD $63 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $64,285 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,464 | | Amount paid for insurance broker fees | 41 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 1951 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $40,985 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,985 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | 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 $19,296 | | Total amount of fees paid to insurance company | USD $851 | | Welfare Benefit Premiums Paid to Carrier | USD $443,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,296 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1823 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $19,624 | | Other welfare benefits provided | AD&D BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $150,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,624 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1628 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $46,912 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $533,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,912 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 19286 |
| Policy instance | 1 |
| Insurance contract or identification number | 19286 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,740 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $43,817 | | 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 | | Additional information about fees paid to insurance broker | EARNED COMMISSION AMOUNT | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $12,021 | | Total amount of fees paid to insurance company | USD $1,247 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $118,931 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,180 | | Amount paid for insurance broker fees | 1247 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1960 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $34,687 | | Total amount of fees paid to insurance company | USD $3,477 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $277,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,687 | | Amount paid for insurance broker fees | 3477 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1193 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $13,203 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $183,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,203 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $17,291 | | Total amount of fees paid to insurance company | USD $4,532 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $82,589 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,060 | | Amount paid for insurance broker fees | 388 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 1942 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $42,597 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,597 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $17,138 | | Total amount of fees paid to insurance company | USD $3 | | Welfare Benefit Premiums Paid to Carrier | USD $434,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $17,138 | | Amount paid for insurance broker fees | 3 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1823 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $19,624 | | Other welfare benefits provided | AD&D BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $150,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,624 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1566 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $49,758 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $625,204 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,758 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 19286 |
| Policy instance | 1 |
| Insurance contract or identification number | 19286 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,070 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $50,947 | | 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 | | Additional information about fees paid to insurance broker | EARNED COMMISSION AMOUNT | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $819 | | Total amount of fees paid to insurance company | USD $317 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $820 | | Amount paid for insurance broker fees | 317 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1192 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,389 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,407 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,389 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 19286 |
| Policy instance | 1 |
| Insurance contract or identification number | 19286 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $724 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $8,615 | | 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 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | EARNED COMMISSION AMOUNT | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1534 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $8,116 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,423 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,116 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1823 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | AD&D BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,332 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $66,081 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,332 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 1922 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,537 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,537 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $4,598 | | Total amount of fees paid to insurance company | USD $7,360 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $14,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,182 | | Amount paid for insurance broker fees | 837 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1919 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $8,487 | | Total amount of fees paid to insurance company | USD $1,040 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $45,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,487 | | Amount paid for insurance broker fees | 1040 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0155184 |
| Policy instance | 9 |
| Insurance contract or identification number | 0155184 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $7,459 | | Total amount of fees paid to insurance company | USD $1,295 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $127,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154277 |
| Policy instance | 8 |
| Insurance contract or identification number | 0154277 | | Number of Individuals Covered | 1935 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $28,831 | | Total amount of fees paid to insurance company | USD $3,086 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $273,594 | | 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: 32395 ) |
| Policy contract number | 30077569 |
| Policy instance | 7 |
| Insurance contract or identification number | 30077569 | | Number of Individuals Covered | 1196 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $12,814 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $180,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | K5X67 |
| Policy instance | 6 |
| Insurance contract or identification number | K5X67 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $33,922 | | Total amount of fees paid to insurance company | USD $22 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $76,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 754112 |
| Policy instance | 5 |
| Insurance contract or identification number | 754112 | | Number of Individuals Covered | 1922 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $29,783 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 603421 |
| Policy instance | 4 |
| Insurance contract or identification number | 603421 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $14,678 | | Welfare Benefit Premiums Paid to Carrier | USD $365,656 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN00944567 |
| Policy instance | 3 |
| Insurance contract or identification number | ADDN00944567 | | Number of Individuals Covered | 1823 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $16,278 | | Other welfare benefits provided | AD&D BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $125,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 19286 |
| Policy instance | 1 |
| Insurance contract or identification number | 19286 | | Number of Individuals Covered | 514 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $6,097 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AFLAC CANCER & AFLAC ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $65,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 535921 |
| Policy instance | 2 |
| Insurance contract or identification number | 535921 | | Number of Individuals Covered | 1560 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $59,421 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $546,821 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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