HIGH POINT UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA
401k plan membership statisitcs for HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA
| Measure | Date | Value |
|---|
| 2022: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-06-01 | 884 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 963 |
| Number of retired or separated participants receiving benefits | 2022-06-01 | 5 |
| Total of all active and inactive participants | 2022-06-01 | 968 |
| 2021: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-06-01 | 817 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 877 |
| Number of retired or separated participants receiving benefits | 2021-06-01 | 7 |
| Total of all active and inactive participants | 2021-06-01 | 884 |
| 2020: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 888 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 813 |
| Number of retired or separated participants receiving benefits | 2020-06-01 | 4 |
| Total of all active and inactive participants | 2020-06-01 | 817 |
| 2019: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 837 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 876 |
| Number of other retired or separated participants entitled to future benefits | 2019-06-01 | 12 |
| Total of all active and inactive participants | 2019-06-01 | 888 |
| 2018: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 808 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 825 |
| Number of other retired or separated participants entitled to future benefits | 2018-06-01 | 12 |
| Total of all active and inactive participants | 2018-06-01 | 837 |
| 2017: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 781 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 800 |
| Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 8 |
| Total of all active and inactive participants | 2017-06-01 | 808 |
| 2016: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 730 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 773 |
| Number of retired or separated participants receiving benefits | 2016-06-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 4 |
| Total of all active and inactive participants | 2016-06-01 | 781 |
| 2015: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 670 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 716 |
| Number of retired or separated participants receiving benefits | 2015-06-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 8 |
| Total of all active and inactive participants | 2015-06-01 | 730 |
| 2022: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2022 form 5500 responses |
|---|
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2021 form 5500 responses |
|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: HIGH POINT UNIVERSITY EMPLOYEE WELFARE BENEFIT PLA 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | First time form 5500 has been submitted | Yes |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 849 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $22,550 | | 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 number | GF3-850-291756 |
| Policy instance | 2 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 849 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $15,621 | | Total amount of fees paid to insurance company | USD $3,726 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,621 | | Amount paid for insurance broker fees | 3726 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 1 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 963 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | Total amount of commissions paid to insurance broker | USD $46,095 | | Total amount of fees paid to insurance company | USD $9,670 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $339,329 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,095 | | Amount paid for insurance broker fees | 9670 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 792 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $556 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $19,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 556 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | GF3-850-291756 |
| Policy instance | 2 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 751 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $18,841 | | Total amount of fees paid to insurance company | USD $1,650 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,203 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,841 | | Amount paid for insurance broker fees | 1650 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 1 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 877 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | Total amount of commissions paid to insurance broker | USD $41,459 | | Total amount of fees paid to insurance company | USD $3,863 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $284,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,459 | | Amount paid for insurance broker fees | 3863 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 1 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 813 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $34,895 | | Total amount of fees paid to insurance company | USD $10,419 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $244,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,895 | | Amount paid for insurance broker fees | 10419 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-850-291756 |
| Policy instance | 2 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 754 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $20,486 | | Total amount of fees paid to insurance company | USD $4,155 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,431 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,486 | | Amount paid for insurance broker fees | 4155 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 733 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $19,239 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28343 |
| Policy instance | 1 |
| Insurance contract or identification number | 28343 | | Number of Individuals Covered | 489 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $11,477 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,477 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 2 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 876 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $41,856 | | Total amount of fees paid to insurance company | USD $10,735 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $300,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,856 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 10419 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 694 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $21,512 | | Total amount of fees paid to insurance company | USD $4,283 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,450 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,512 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4155 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 4 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 909 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $25,040 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3341810 |
| Policy instance | 6 |
| Insurance contract or identification number | 3341810 | | Number of Individuals Covered | 622 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $45,802 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $463,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,802 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 5 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 853 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $22,108 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-850-291756 |
| Policy instance | 4 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 667 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $20,011 | | Total amount of fees paid to insurance company | USD $1,115 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,430 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,011 | | Amount paid for insurance broker fees | 1115 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 825 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $31,983 | | Total amount of fees paid to insurance company | USD $2,711 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $212,450 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,983 | | Amount paid for insurance broker fees | 2711 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28343 |
| Policy instance | 2 |
| Insurance contract or identification number | 28343 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $14,666 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $122,229 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,666 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
| Policy contract number | 057360 |
| Policy instance | 1 |
| Insurance contract or identification number | 057360 | | Number of Individuals Covered | 1211 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $122,901 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | 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 $122,901 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
| Policy contract number | 057360 |
| Policy instance | 1 |
| Insurance contract or identification number | 057360 | | Number of Individuals Covered | 1236 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $155,775 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | 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 $155,775 | | Insurance broker organization code? | 3 | | Insurance broker name | LISA HAMLETT |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28343 |
| Policy instance | 2 |
| Insurance contract or identification number | 28343 | | Number of Individuals Covered | 764 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $10,673 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,673 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES NATIONAL INC |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA3-850-291756 |
| Policy instance | 3 |
| Insurance contract or identification number | SA3-850-291756 | | Number of Individuals Covered | 805 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $23,220 | | Total amount of fees paid to insurance company | USD $3,617 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $197,259 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,220 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3617 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-850-291756 |
| Policy instance | 4 |
| Insurance contract or identification number | GF3-850-291756 | | Number of Individuals Covered | 552 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $15,347 | | Total amount of fees paid to insurance company | USD $1,589 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,334 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,347 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1589 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD3-850-291756 |
| Policy instance | 5 |
| Insurance contract or identification number | PD3-850-291756 | | Number of Individuals Covered | 823 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $86 | | Other welfare benefits provided | LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $20,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 86 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 28343 |
| Policy instance | 3 |
| Insurance contract or identification number | 28343 | | Number of Individuals Covered | 655 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $7,603 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,603 | | Insurance broker organization code? | 3 | | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
|
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
| Policy contract number | 057360 |
| Policy instance | 2 |
| Insurance contract or identification number | 057360 | | Number of Individuals Covered | 1109 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $119,930 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | 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 $119,930 | | Insurance broker organization code? | 3 | | Insurance broker name | LISA L HAMLETT |
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 873477G |
| Policy instance | 1 |
| Insurance contract or identification number | 873477G | | Number of Individuals Covered | 879 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $41,625 | | Total amount of fees paid to insurance company | USD $1,183 | | 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 $207,866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,625 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1183 | | Additional information about fees paid to insurance broker | BONUS PAID | | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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