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WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 401k Plan overview

Plan NameWOODS ROGERS PLC EMPLOYEES INSURANCE PLAN
Plan identification number 501

WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

WOODS ROGERS VANDEVENTER BLACK PLC has sponsored the creation of one or more 401k plans.

Company Name:WOODS ROGERS VANDEVENTER BLACK PLC
Employer identification number (EIN):541294386
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Additional information about WOODS ROGERS VANDEVENTER BLACK PLC

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1993-11-29
Company Identification Number: S002995
Legal Registered Office Address: DOMINION TOWER, SUITE 1400

ROANOKE
United States of America (USA)
24011

More information about WOODS ROGERS VANDEVENTER BLACK PLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01RICHARD WOLF
5012017-01-01GEORGE LELOUDIS
5012016-01-01GEORGE LELOUDIS
5012015-01-01GEORGE LELOUDIS GEORGE LELOUDIS2016-07-21
5012014-01-01GEORGE LELOUDIS GEORGE LELOUDIS2015-07-17
5012013-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012012-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012011-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012010-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012009-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012008-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012007-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012006-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012005-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012004-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012003-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23
5012002-01-01GEORGE LELOUDIS GEORGE LELOUDIS2014-12-23

Plan Statistics for WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN

401k plan membership statisitcs for WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN

Measure Date Value
2021: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01137
Total number of active participants reported on line 7a of the Form 55002021-01-01132
Total of all active and inactive participants2021-01-01132
Total participants2021-01-01132
2020: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01130
Total number of active participants reported on line 7a of the Form 55002020-01-01137
Total of all active and inactive participants2020-01-01137
Total participants2020-01-01137
2019: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01123
Total number of active participants reported on line 7a of the Form 55002019-01-01130
Total of all active and inactive participants2019-01-01130
Total participants2019-01-01130
Number of participants with account balances2019-01-010
2018: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01126
Total number of active participants reported on line 7a of the Form 55002018-01-01123
Total of all active and inactive participants2018-01-01123
Total participants2018-01-01123
2017: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01122
Total number of active participants reported on line 7a of the Form 55002017-01-01126
Total of all active and inactive participants2017-01-01126
Total participants2017-01-01126
2016: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01231
Total number of active participants reported on line 7a of the Form 55002016-01-01122
Total of all active and inactive participants2016-01-01122
Total participants2016-01-01122
2015: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01250
Total number of active participants reported on line 7a of the Form 55002015-01-01231
Total of all active and inactive participants2015-01-01231
2014: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01152
Total number of active participants reported on line 7a of the Form 55002014-01-01250
Total of all active and inactive participants2014-01-01250
2013: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01142
Total number of active participants reported on line 7a of the Form 55002013-01-01152
Total of all active and inactive participants2013-01-01152
2012: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01239
Total number of active participants reported on line 7a of the Form 55002012-01-01142
Total of all active and inactive participants2012-01-01142
2011: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01104
Total number of active participants reported on line 7a of the Form 55002011-01-01239
Total of all active and inactive participants2011-01-01239
2010: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01104
Total number of active participants reported on line 7a of the Form 55002010-01-01104
Total of all active and inactive participants2010-01-01104
2009: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01111
Total number of active participants reported on line 7a of the Form 55002009-01-01104
Total of all active and inactive participants2009-01-01104
2008: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01111
Total number of active participants reported on line 7a of the Form 55002008-01-01111
Total of all active and inactive participants2008-01-01111
2007: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01110
Total number of active participants reported on line 7a of the Form 55002007-01-01111
Total of all active and inactive participants2007-01-01111
2006: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01110
Total number of active participants reported on line 7a of the Form 55002006-01-01110
Total of all active and inactive participants2006-01-01110
2005: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01109
Total number of active participants reported on line 7a of the Form 55002005-01-01110
Total of all active and inactive participants2005-01-01110
2004: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01133
Total number of active participants reported on line 7a of the Form 55002004-01-01109
Total of all active and inactive participants2004-01-01109
2003: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01148
Total number of active participants reported on line 7a of the Form 55002003-01-01133
Total of all active and inactive participants2003-01-01133
2002: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01148
Total number of active participants reported on line 7a of the Form 55002002-01-01140
Number of retired or separated participants receiving benefits2002-01-018
Total of all active and inactive participants2002-01-01148

Form 5500 Responses for WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN

2021: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – General assets of the sponsorYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – General assets of the sponsorYes
2005: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – General assets of the sponsorYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – General assets of the sponsorYes
2004: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan funding arrangement – General assets of the sponsorYes
2004-01-01Plan benefit arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – General assets of the sponsorYes
2003: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan funding arrangement – General assets of the sponsorYes
2003-01-01Plan benefit arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – General assets of the sponsorYes
2002: WOODS ROGERS PLC EMPLOYEES INSURANCE PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan funding arrangement – General assets of the sponsorYes
2002-01-01Plan benefit arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract number0768007HNO
Policy instance 4
Insurance contract or identification number0768007HNO
Number of Individuals Covered229
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $2,036
Welfare Benefit Premiums Paid to CarrierUSD $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 BrokerUSD $2,036
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1102165
Policy instance 3
Insurance contract or identification number1102165
Number of Individuals Covered176
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $37,440
Total amount of fees paid to insurance companyUSD $6,302
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,035
Amount paid for insurance broker fees6302
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 2
Insurance contract or identification number131389
Number of Individuals Covered265
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $2,270
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,270
Insurance broker organization code?3
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered266
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,491
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,491
Insurance broker organization code?3
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered251
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $4,564
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,564
Insurance broker organization code?3
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 2
Insurance contract or identification number131389
Number of Individuals Covered258
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $2,204
Total amount of fees paid to insurance companyUSD $121
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,204
Amount paid for insurance broker fees121
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1102165
Policy instance 3
Insurance contract or identification number1102165
Number of Individuals Covered187
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $35,318
Total amount of fees paid to insurance companyUSD $162
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,163
Amount paid for insurance broker fees162
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract number0768007HNO
Policy instance 4
Insurance contract or identification number0768007HNO
Number of Individuals Covered222
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Welfare Benefit Premiums Paid to CarrierUSD $1,429,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract number0768007HNO
Policy instance 4
Insurance contract or identification number0768007HNO
Number of Individuals Covered249
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Welfare Benefit Premiums Paid to CarrierUSD $1,376,376
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 number1102165
Policy instance 3
Insurance contract or identification number1102165
Number of Individuals Covered176
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $32,750
Total amount of fees paid to insurance companyUSD $7,350
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $192,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,900
Amount paid for insurance broker fees7350
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 2
Insurance contract or identification number131389
Number of Individuals Covered257
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $2,635
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,635
Insurance broker organization code?3
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered256
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $4,941
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,941
Insurance broker organization code?3
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered250
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $5,874
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,874
Insurance broker organization code?3
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 2
Insurance contract or identification number131389
Number of Individuals Covered250
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $1,503
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,503
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10186038
Policy instance 3
Insurance contract or identification number10186038
Number of Individuals Covered123
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $12,277
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,277
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract number0768007HNO
Policy instance 4
Insurance contract or identification number0768007HNO
Number of Individuals Covered251
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $44,514
Welfare Benefit Premiums Paid to CarrierUSD $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 BrokerUSD $44,514
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10186039
Policy instance 5
Insurance contract or identification number10186039
Number of Individuals Covered124
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $14,391
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,391
Insurance broker organization code?3
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered278
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $6,349
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,349
Insurance broker organization code?3
Insurance broker nameINNOVATIVE INSURANCE GROUP LLC
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberB5K0Z
Policy instance 2
Insurance contract or identification numberB5K0Z
Number of Individuals Covered176
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $31,800
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $947,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,800
Insurance broker organization code?3
Insurance broker nameINNOVATIVE INSURANCE GROUP LLC
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 3
Insurance contract or identification number131389
Number of Individuals Covered278
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $2,093
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,093
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10186038
Policy instance 4
Insurance contract or identification number10186038
Number of Individuals Covered126
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $28,372
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $189,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,372
Insurance broker organization code?3
Insurance broker nameINNOVATIVE INSURANCE GROUP LLC
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract numberB5K0Z
Policy instance 5
Insurance contract or identification numberB5K0Z
Number of Individuals Covered102
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $510,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 3
Insurance contract or identification number131389
Number of Individuals Covered97
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $1,978
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,978
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract numberB5K0Z
Policy instance 5
Insurance contract or identification numberB5K0Z
Number of Individuals Covered59
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $641,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker name
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10186038
Policy instance 4
Insurance contract or identification number10186038
Number of Individuals Covered103
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $23,440
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $156,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,516
Insurance broker organization code?3
Insurance broker nameINNOVATIVE INSURANCE GROUP LLC
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberB5K0Z
Policy instance 2
Insurance contract or identification numberB5K0Z
Number of Individuals Covered38
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $25,050
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,900
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered231
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $5,311
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,358
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )
Policy contract number000500290
Policy instance 1
Insurance contract or identification number000500290
Number of Individuals Covered250
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $6,839
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,839
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract numberB5K0Z
Policy instance 5
Insurance contract or identification numberB5K0Z
Number of Individuals Covered34
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $352,488
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: 65676 )
Policy contract number10186038
Policy instance 4
Insurance contract or identification number10186038
Number of Individuals Covered110
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,563
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $157,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,563
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 3
Insurance contract or identification number131389
Number of Individuals Covered101
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $2,064
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,064
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberB5K0Z
Policy instance 2
Insurance contract or identification numberB5K0Z
Number of Individuals Covered67
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $33,900
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $640,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,900
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberAVA6739671
Policy instance 1
Insurance contract or identification numberAVA6739671
Number of Individuals Covered99
Insurance policy start date2013-01-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $3,716
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,716
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
SH-COVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 96555 )
Policy contract number9320130000
Policy instance 2
Insurance contract or identification number9320130000
Number of Individuals Covered37
Insurance policy start date2013-01-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $16,845
Total amount of fees paid to insurance companyUSD $4,685
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $307,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,845
Amount paid for insurance broker fees4685
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 )
Policy contract number131389
Policy instance 3
Insurance contract or identification number131389
Number of Individuals Covered99
Insurance policy start date2013-01-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $1,609
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,609
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1015795
Policy instance 4
Insurance contract or identification number1015795
Number of Individuals Covered152
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $19,526
Total amount of fees paid to insurance companyUSD $2,918
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $145,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,526
Insurance broker organization code?3
Amount paid for insurance broker fees2918
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker nameGARRY LYNN JOHNSON
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number9320130000
Policy instance 5
Insurance contract or identification number9320130000
Number of Individuals Covered59
Insurance policy start date2013-01-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $28,359
Total amount of fees paid to insurance companyUSD $8,508
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $519,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,359
Amount paid for insurance broker fees8508
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1015795
Policy instance 2
Insurance contract or identification number1015795
Number of Individuals Covered142
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $19,112
Total amount of fees paid to insurance companyUSD $2,850
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $142,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,112
Insurance broker organization code?3
Amount paid for insurance broker fees2850
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker nameGARRY LYNN JOHNSON
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberA2S81
Policy instance 1
Insurance contract or identification numberA2S81
Number of Individuals Covered64
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $18,104
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $709,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,104
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1015795
Policy instance 3
Insurance contract or identification number1015795
Number of Individuals Covered111
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $25,953
Total amount of fees paid to insurance companyUSD $5,106
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $263,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 )
Policy contract number9319260000
Policy instance 2
Insurance contract or identification number9319260000
Number of Individuals Covered239
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $20,711
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $828,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 1
Insurance contract or identification number00366608
Number of Individuals Covered104
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $10,756
Total amount of fees paid to insurance companyUSD $6,051
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $290,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract numberA2S81
Policy instance 2
Insurance contract or identification numberA2S81
Number of Individuals Covered102
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $19,142
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $957,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 1
Insurance contract or identification number00366608
Number of Individuals Covered104
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $14,285
Total amount of fees paid to insurance companyUSD $7,866
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $306,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered104
Insurance policy start date2008-02-01
Insurance policy end date2009-01-31
Total amount of commissions paid to insurance brokerUSD $14,166
Total amount of fees paid to insurance companyUSD $7,824
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $294,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,075
Amount paid for insurance broker fees7824
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameASSET MANAGEMENT GROUP, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered100
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $17,218
Total amount of fees paid to insurance companyUSD $875
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $843,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,218
Amount paid for insurance broker fees875
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered111
Insurance policy start date2007-02-01
Insurance policy end date2008-01-31
Total amount of commissions paid to insurance brokerUSD $13,431
Total amount of fees paid to insurance companyUSD $6,670
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $272,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,346
Amount paid for insurance broker fees6670
Additional information about fees paid to insurance brokerSPECIAL PRODUCER COMPENSATION
Insurance broker organization code?3
Insurance broker nameASSET MANAGEMENT GROUP, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered100
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $15,558
Total amount of fees paid to insurance companyUSD $322
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $762,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,558
Amount paid for insurance broker fees322
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered111
Insurance policy start date2006-02-01
Insurance policy end date2007-01-31
Total amount of commissions paid to insurance brokerUSD $16,174
Total amount of fees paid to insurance companyUSD $5,889
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,064
Amount paid for insurance broker fees5889
Additional information about fees paid to insurance brokerSPECIAL PRODUCER COMPENSATION
Insurance broker organization code?3
Insurance broker nameASSET MANAGEMENT GROUP, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered92
Insurance policy start date2007-01-01
Insurance policy end date2007-12-31
Total amount of commissions paid to insurance brokerUSD $17,669
Total amount of fees paid to insurance companyUSD $1,940
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $865,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,669
Amount paid for insurance broker fees1940
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered110
Insurance policy start date2005-02-01
Insurance policy end date2006-01-31
Total amount of commissions paid to insurance brokerUSD $11,806
Total amount of fees paid to insurance companyUSD $5,191
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $181,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,626
Amount paid for insurance broker fees5191
Additional information about fees paid to insurance brokerSPECIAL PRODUCER COMPENSATION
Insurance broker organization code?3
Insurance broker nameJONATHAN PHAN
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered106
Insurance policy start date2006-01-01
Insurance policy end date2006-12-31
Total amount of commissions paid to insurance brokerUSD $21,027
Total amount of fees paid to insurance companyUSD $589
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 BrokerUSD $21,027
Amount paid for insurance broker fees589
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered107
Insurance policy start date2005-01-01
Insurance policy end date2005-12-31
Total amount of commissions paid to insurance brokerUSD $18,729
Total amount of fees paid to insurance companyUSD $995
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $917,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,729
Amount paid for insurance broker fees995
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered110
Insurance policy start date2004-02-01
Insurance policy end date2005-01-31
Total amount of commissions paid to insurance brokerUSD $9,105
Total amount of fees paid to insurance companyUSD $2,995
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,105
Amount paid for insurance broker fees2995
Additional information about fees paid to insurance brokerSPECIAL PRODUCER COMPENSATION
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered109
Insurance policy start date2003-02-01
Insurance policy end date2004-01-31
Total amount of commissions paid to insurance brokerUSD $8,844
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,844
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered109
Insurance policy start date2004-01-01
Insurance policy end date2004-12-31
Total amount of commissions paid to insurance brokerUSD $18,296
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $896,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,296
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00366608
Policy instance 2
Insurance contract or identification number00366608
Number of Individuals Covered133
Insurance policy start date2002-02-01
Insurance policy end date2003-01-31
Total amount of commissions paid to insurance brokerUSD $10,670
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,670
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered113
Insurance policy start date2003-01-01
Insurance policy end date2003-12-31
Total amount of commissions paid to insurance brokerUSD $17,540
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $858,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,540
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number43592
Policy instance 1
Insurance contract or identification number43592
Number of Individuals Covered140
Insurance policy start date2002-01-01
Insurance policy end date2002-12-31
Total amount of commissions paid to insurance brokerUSD $1,618
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,618
Insurance broker organization code?3
Insurance broker nameBENEFITS GROUP INC. - CHARLES WEBB

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