WOODS ROGERS VANDEVENTER BLACK PLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN
401k plan membership statisitcs for WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN
Measure | Date | Value |
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2023: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2023 401k membership |
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Total participants, beginning-of-year | 2023-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 255 |
Total of all active and inactive participants | 2023-01-01 | 255 |
Total participants | 2023-01-01 | 255 |
2021: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 137 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 132 |
Total of all active and inactive participants | 2021-01-01 | 132 |
Total participants | 2021-01-01 | 132 |
2020: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 130 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 137 |
Total of all active and inactive participants | 2020-01-01 | 137 |
Total participants | 2020-01-01 | 137 |
2019: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 130 |
Total of all active and inactive participants | 2019-01-01 | 130 |
Total participants | 2019-01-01 | 130 |
Number of participants with account balances | 2019-01-01 | 0 |
2018: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 126 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 123 |
Total of all active and inactive participants | 2018-01-01 | 123 |
Total participants | 2018-01-01 | 123 |
2017: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 122 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 126 |
Total of all active and inactive participants | 2017-01-01 | 126 |
Total participants | 2017-01-01 | 126 |
2016: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 231 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 122 |
Total of all active and inactive participants | 2016-01-01 | 122 |
Total participants | 2016-01-01 | 122 |
2015: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 250 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 231 |
Total of all active and inactive participants | 2015-01-01 | 231 |
2014: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 152 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 250 |
Total of all active and inactive participants | 2014-01-01 | 250 |
2013: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 152 |
Total of all active and inactive participants | 2013-01-01 | 152 |
2012: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 239 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 142 |
Total of all active and inactive participants | 2012-01-01 | 142 |
2011: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 239 |
Total of all active and inactive participants | 2011-01-01 | 239 |
2010: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 104 |
Total of all active and inactive participants | 2010-01-01 | 104 |
2009: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 104 |
Total of all active and inactive participants | 2009-01-01 | 104 |
2008: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-01-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-01-01 | 111 |
Total of all active and inactive participants | 2008-01-01 | 111 |
2007: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-01-01 | 110 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-01-01 | 111 |
Total of all active and inactive participants | 2007-01-01 | 111 |
2006: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-01-01 | 110 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-01-01 | 110 |
Total of all active and inactive participants | 2006-01-01 | 110 |
2005: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-01-01 | 109 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-01-01 | 110 |
Total of all active and inactive participants | 2005-01-01 | 110 |
2004: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2004 401k membership |
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Total participants, beginning-of-year | 2004-01-01 | 133 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-01-01 | 109 |
Total of all active and inactive participants | 2004-01-01 | 109 |
2003: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2003 401k membership |
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Total participants, beginning-of-year | 2003-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2003-01-01 | 133 |
Total of all active and inactive participants | 2003-01-01 | 133 |
2002: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2002 401k membership |
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Total participants, beginning-of-year | 2002-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2002-01-01 | 140 |
Number of retired or separated participants receiving benefits | 2002-01-01 | 8 |
Total of all active and inactive participants | 2002-01-01 | 148 |
2023: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2023 form 5500 responses |
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2023-01-01 | Type of plan entity | Single employer plan |
2023-01-01 | Plan funding arrangement – Insurance | Yes |
2023-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2008: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2008 form 5500 responses |
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2008-01-01 | Type of plan entity | Single employer plan |
2008-01-01 | Plan funding arrangement – Insurance | Yes |
2008-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2008-01-01 | Plan benefit arrangement – Insurance | Yes |
2008-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2007: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2007 form 5500 responses |
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2007-01-01 | Type of plan entity | Single employer plan |
2007-01-01 | Plan funding arrangement – Insurance | Yes |
2007-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2007-01-01 | Plan benefit arrangement – Insurance | Yes |
2007-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2006: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2006 form 5500 responses |
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2006-01-01 | Type of plan entity | Single employer plan |
2006-01-01 | Plan funding arrangement – Insurance | Yes |
2006-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2006-01-01 | Plan benefit arrangement – Insurance | Yes |
2006-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2005: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2005 form 5500 responses |
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2005-01-01 | Type of plan entity | Single employer plan |
2005-01-01 | Plan funding arrangement – Insurance | Yes |
2005-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2005-01-01 | Plan benefit arrangement – Insurance | Yes |
2005-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2004: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2004 form 5500 responses |
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2004-01-01 | Type of plan entity | Single employer plan |
2004-01-01 | Plan funding arrangement – Insurance | Yes |
2004-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2004-01-01 | Plan benefit arrangement – Insurance | Yes |
2004-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2003: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2003 form 5500 responses |
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2003-01-01 | Type of plan entity | Single employer plan |
2003-01-01 | Plan funding arrangement – Insurance | Yes |
2003-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2003-01-01 | Plan benefit arrangement – Insurance | Yes |
2003-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2002: WOODS ROGERS VANDEVENTER BLACK PLC EMPLOYEES INSURANCE PLAN 2002 form 5500 responses |
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2002-01-01 | Type of plan entity | Single employer plan |
2002-01-01 | Plan funding arrangement – Insurance | Yes |
2002-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2002-01-01 | Plan benefit arrangement – Insurance | Yes |
2002-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 957482 |
Policy instance | 4 |
Insurance contract or identification number | 957482 | Number of Individuals Covered | 255 | Insurance policy start date | 2022-12-01 | Insurance policy end date | 2023-11-30 | Total amount of commissions paid to insurance broker | USD $61,882 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $402,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 ) |
Policy contract number | L06933 |
Policy instance | 3 |
Insurance contract or identification number | L06933 | Number of Individuals Covered | 171 | Insurance policy start date | 2022-12-01 | Insurance policy end date | 2023-11-30 | Total amount of commissions paid to insurance broker | USD $71,591 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,923,291 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | L06933 |
Policy instance | 2 |
Insurance contract or identification number | L06933 | Number of Individuals Covered | 90 | Insurance policy start date | 2022-12-01 | Insurance policy end date | 2023-11-30 | Total amount of commissions paid to insurance broker | USD $30,682 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $837,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 398 | Insurance policy start date | 2022-12-01 | Insurance policy end date | 2023-11-30 | Total amount of commissions paid to insurance broker | USD $8,346 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 266 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,491 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,491 | Insurance broker organization code? | 3 |
|
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 2 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 265 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $2,270 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,705 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,270 | Insurance broker organization code? | 3 |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1102165 |
Policy instance | 3 |
Insurance contract or identification number | 1102165 | Number of Individuals Covered | 176 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $37,440 | Total amount of fees paid to insurance company | USD $6,302 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $219,849 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,035 | Amount paid for insurance broker fees | 6302 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0768007HNO |
Policy instance | 4 |
Insurance contract or identification number | 0768007HNO | Number of Individuals Covered | 229 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $2,036 | Welfare Benefit Premiums Paid to Carrier | USD $1,703,456 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,036 | Insurance broker organization code? | 3 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0768007HNO |
Policy instance | 4 |
Insurance contract or identification number | 0768007HNO | Number of Individuals Covered | 222 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Welfare Benefit Premiums Paid to Carrier | USD $1,429,996 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1102165 |
Policy instance | 3 |
Insurance contract or identification number | 1102165 | Number of Individuals Covered | 187 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $35,318 | Total amount of fees paid to insurance company | USD $162 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $207,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,163 | Amount paid for insurance broker fees | 162 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 2 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 258 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $2,204 | Total amount of fees paid to insurance company | USD $121 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,204 | Amount paid for insurance broker fees | 121 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 251 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $4,564 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,564 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 256 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $4,941 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,941 | Insurance broker organization code? | 3 |
|
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 2 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 257 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $2,635 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,635 | Insurance broker organization code? | 3 |
|
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1102165 |
Policy instance | 3 |
Insurance contract or identification number | 1102165 | Number of Individuals Covered | 176 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $32,750 | Total amount of fees paid to insurance company | USD $7,350 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $192,475 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,900 | Amount paid for insurance broker fees | 7350 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0768007HNO |
Policy instance | 4 |
Insurance contract or identification number | 0768007HNO | Number of Individuals Covered | 249 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Welfare Benefit Premiums Paid to Carrier | USD $1,376,376 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 10186039 |
Policy instance | 5 |
Insurance contract or identification number | 10186039 | Number of Individuals Covered | 124 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $14,391 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $95,942 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,391 | Insurance broker organization code? | 3 |
|
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
Policy contract number | 0768007HNO |
Policy instance | 4 |
Insurance contract or identification number | 0768007HNO | Number of Individuals Covered | 251 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $44,514 | Welfare Benefit Premiums Paid to Carrier | USD $1,167,690 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,514 |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 10186038 |
Policy instance | 3 |
Insurance contract or identification number | 10186038 | Number of Individuals Covered | 123 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $12,277 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $81,847 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,277 | Insurance broker organization code? | 3 |
|
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 2 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 250 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $1,503 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,976 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,503 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 250 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $5,874 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,874 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 278 | Insurance policy start date | 2016-12-01 | Insurance policy end date | 2017-11-30 | Total amount of commissions paid to insurance broker | USD $6,349 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $125,680 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,349 | Insurance broker organization code? | 3 | Insurance broker name | INNOVATIVE INSURANCE GROUP LLC |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | B5K0Z |
Policy instance | 2 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 176 | Insurance policy start date | 2016-12-01 | Insurance policy end date | 2017-11-30 | Total amount of commissions paid to insurance broker | USD $31,800 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $947,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,800 | Insurance broker organization code? | 3 | Insurance broker name | INNOVATIVE INSURANCE GROUP LLC |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 3 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 278 | Insurance policy start date | 2016-12-01 | Insurance policy end date | 2017-11-30 | Total amount of commissions paid to insurance broker | USD $2,093 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,846 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,093 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 10186038 |
Policy instance | 4 |
Insurance contract or identification number | 10186038 | Number of Individuals Covered | 126 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $28,372 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $189,146 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,372 | Insurance broker organization code? | 3 | Insurance broker name | INNOVATIVE INSURANCE GROUP LLC |
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HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 ) |
Policy contract number | B5K0Z |
Policy instance | 5 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 102 | Insurance policy start date | 2016-12-01 | Insurance policy end date | 2017-11-30 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $510,010 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 ) |
Policy contract number | B5K0Z |
Policy instance | 5 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 59 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $641,513 | 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 | Insurance broker name | |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 10186038 |
Policy instance | 4 |
Insurance contract or identification number | 10186038 | Number of Individuals Covered | 103 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $23,440 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $156,265 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,516 | Insurance broker organization code? | 3 | Insurance broker name | INNOVATIVE INSURANCE GROUP LLC |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 3 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 97 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $1,978 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,602 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,978 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | B5K0Z |
Policy instance | 2 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 38 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $25,050 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $365,198 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,900 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 231 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $5,311 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,358 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | B5K0Z |
Policy instance | 2 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 67 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $33,900 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $640,223 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,900 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 3 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 101 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $2,064 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,064 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) |
Policy contract number | 10186038 |
Policy instance | 4 |
Insurance contract or identification number | 10186038 | Number of Individuals Covered | 110 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $23,563 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $157,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,563 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 ) |
Policy contract number | 000500290 |
Policy instance | 1 |
Insurance contract or identification number | 000500290 | Number of Individuals Covered | 250 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $6,839 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $106,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,839 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. |
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HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 ) |
Policy contract number | B5K0Z |
Policy instance | 5 |
Insurance contract or identification number | B5K0Z | Number of Individuals Covered | 34 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $352,488 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
Policy contract number | 131389 |
Policy instance | 3 |
Insurance contract or identification number | 131389 | Number of Individuals Covered | 99 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $1,609 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,758 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,609 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 9320130000 |
Policy instance | 5 |
Insurance contract or identification number | 9320130000 | Number of Individuals Covered | 59 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $28,359 | Total amount of fees paid to insurance company | USD $8,508 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $519,498 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,359 | Amount paid for insurance broker fees | 8508 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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SH-COVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 96555 ) |
Policy contract number | 9320130000 |
Policy instance | 2 |
Insurance contract or identification number | 9320130000 | Number of Individuals Covered | 37 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $16,845 | Total amount of fees paid to insurance company | USD $4,685 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $307,541 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,845 | Amount paid for insurance broker fees | 4685 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | AVA6739671 |
Policy instance | 1 |
Insurance contract or identification number | AVA6739671 | Number of Individuals Covered | 99 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $3,716 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $74,304 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,716 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1015795 |
Policy instance | 4 |
Insurance contract or identification number | 1015795 | Number of Individuals Covered | 152 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $19,526 | Total amount of fees paid to insurance company | USD $2,918 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $145,891 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,526 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2918 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker name | GARRY LYNN JOHNSON |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1015795 |
Policy instance | 2 |
Insurance contract or identification number | 1015795 | Number of Individuals Covered | 142 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $19,112 | Total amount of fees paid to insurance company | USD $2,850 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $142,201 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,112 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2850 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker name | GARRY LYNN JOHNSON |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | A2S81 |
Policy instance | 1 |
Insurance contract or identification number | A2S81 | Number of Individuals Covered | 64 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $18,104 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $709,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,104 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1015795 |
Policy instance | 3 |
Insurance contract or identification number | 1015795 | Number of Individuals Covered | 111 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $25,953 | Total amount of fees paid to insurance company | USD $5,106 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $263,698 | 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 | 9319260000 |
Policy instance | 2 |
Insurance contract or identification number | 9319260000 | Number of Individuals Covered | 239 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $20,711 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $828,458 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 1 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 104 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $10,756 | Total amount of fees paid to insurance company | USD $6,051 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $290,638 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | A2S81 |
Policy instance | 2 |
Insurance contract or identification number | A2S81 | Number of Individuals Covered | 102 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $19,142 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $957,075 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 1 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 104 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $14,285 | Total amount of fees paid to insurance company | USD $7,866 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $306,630 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 104 | Insurance policy start date | 2008-02-01 | Insurance policy end date | 2009-01-31 | Total amount of commissions paid to insurance broker | USD $14,166 | Total amount of fees paid to insurance company | USD $7,824 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $294,888 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,075 | Amount paid for insurance broker fees | 7824 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ASSET MANAGEMENT GROUP, INC. |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 100 | Insurance policy start date | 2009-01-01 | Insurance policy end date | 2009-12-31 | Total amount of commissions paid to insurance broker | USD $17,218 | Total amount of fees paid to insurance company | USD $875 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $843,685 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,218 | Amount paid for insurance broker fees | 875 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 111 | Insurance policy start date | 2007-02-01 | Insurance policy end date | 2008-01-31 | Total amount of commissions paid to insurance broker | USD $13,431 | Total amount of fees paid to insurance company | USD $6,670 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $272,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,346 | Amount paid for insurance broker fees | 6670 | Additional information about fees paid to insurance broker | SPECIAL PRODUCER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ASSET MANAGEMENT GROUP, INC. |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 100 | Insurance policy start date | 2008-01-01 | Insurance policy end date | 2008-12-31 | Total amount of commissions paid to insurance broker | USD $15,558 | Total amount of fees paid to insurance company | USD $322 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $762,341 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,558 | Amount paid for insurance broker fees | 322 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 111 | Insurance policy start date | 2006-02-01 | Insurance policy end date | 2007-01-31 | Total amount of commissions paid to insurance broker | USD $16,174 | Total amount of fees paid to insurance company | USD $5,889 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $238,860 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,064 | Amount paid for insurance broker fees | 5889 | Additional information about fees paid to insurance broker | SPECIAL PRODUCER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ASSET MANAGEMENT GROUP, INC. |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 92 | Insurance policy start date | 2007-01-01 | Insurance policy end date | 2007-12-31 | Total amount of commissions paid to insurance broker | USD $17,669 | Total amount of fees paid to insurance company | USD $1,940 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $865,771 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,669 | Amount paid for insurance broker fees | 1940 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 110 | Insurance policy start date | 2005-02-01 | Insurance policy end date | 2006-01-31 | Total amount of commissions paid to insurance broker | USD $11,806 | Total amount of fees paid to insurance company | USD $5,191 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $181,628 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,626 | Amount paid for insurance broker fees | 5191 | Additional information about fees paid to insurance broker | SPECIAL PRODUCER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | JONATHAN PHAN |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 106 | Insurance policy start date | 2006-01-01 | Insurance policy end date | 2006-12-31 | Total amount of commissions paid to insurance broker | USD $21,027 | Total amount of fees paid to insurance company | USD $589 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,031,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,027 | Amount paid for insurance broker fees | 589 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 107 | Insurance policy start date | 2005-01-01 | Insurance policy end date | 2005-12-31 | Total amount of commissions paid to insurance broker | USD $18,729 | Total amount of fees paid to insurance company | USD $995 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $917,713 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,729 | Amount paid for insurance broker fees | 995 | Additional information about fees paid to insurance broker | BONUS COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 110 | Insurance policy start date | 2004-02-01 | Insurance policy end date | 2005-01-31 | Total amount of commissions paid to insurance broker | USD $9,105 | Total amount of fees paid to insurance company | USD $2,995 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $141,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,105 | Amount paid for insurance broker fees | 2995 | Additional information about fees paid to insurance broker | SPECIAL PRODUCER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 109 | Insurance policy start date | 2003-02-01 | Insurance policy end date | 2004-01-31 | Total amount of commissions paid to insurance broker | USD $8,844 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $128,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,844 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 109 | Insurance policy start date | 2004-01-01 | Insurance policy end date | 2004-12-31 | Total amount of commissions paid to insurance broker | USD $18,296 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $896,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,296 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00366608 |
Policy instance | 2 |
Insurance contract or identification number | 00366608 | Number of Individuals Covered | 133 | Insurance policy start date | 2002-02-01 | Insurance policy end date | 2003-01-31 | Total amount of commissions paid to insurance broker | USD $10,670 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $158,314 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,670 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 113 | Insurance policy start date | 2003-01-01 | Insurance policy end date | 2003-12-31 | Total amount of commissions paid to insurance broker | USD $17,540 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $858,380 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,540 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
Policy contract number | 43592 |
Policy instance | 1 |
Insurance contract or identification number | 43592 | Number of Individuals Covered | 140 | Insurance policy start date | 2002-01-01 | Insurance policy end date | 2002-12-31 | Total amount of commissions paid to insurance broker | USD $1,618 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,618 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS GROUP INC. - CHARLES WEBB |
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