ALARIS HOMES, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE CARROLL COMPANIES DBA ALARIS HOMES, INC F/K/A OLD SOUTH HOME COMPANY
401k plan membership statisitcs for THE CARROLL COMPANIES DBA ALARIS HOMES, INC F/K/A OLD SOUTH HOME COMPANY
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10096901001 |
Policy instance | 2 |
Insurance contract or identification number | 10096901001 | Number of Individuals Covered | 253 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,491 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,180 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $983 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10183511001 |
Policy instance | 7 |
Insurance contract or identification number | 10183511001 | Number of Individuals Covered | 1 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0BK22 |
Policy instance | 6 |
Insurance contract or identification number | GVTL0BK22 | Number of Individuals Covered | 120 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $6,151 | Total amount of fees paid to insurance company | USD $1,034 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $30,756 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,151 | Amount paid for insurance broker fees | 1034 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUPR0BK22 |
Policy instance | 5 |
Insurance contract or identification number | GUPR0BK22 | Number of Individuals Covered | 88 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $1,645 | Total amount of fees paid to insurance company | USD $1,290 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,894 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,645 | Amount paid for insurance broker fees | 1290 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUC0BK22 |
Policy instance | 4 |
Insurance contract or identification number | GUC0BK22 | Number of Individuals Covered | 100 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $8,309 | Total amount of fees paid to insurance company | USD $1,816 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,546 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,309 | Amount paid for insurance broker fees | 1816 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BK22 |
Policy instance | 3 |
Insurance contract or identification number | GLUG0BK22 | Number of Individuals Covered | 314 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $1,343 | Total amount of fees paid to insurance company | USD $340 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,954 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,343 | Amount paid for insurance broker fees | 340 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 1 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 87 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $19,980 | Total amount of fees paid to insurance company | USD $13,988 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, CANCER, AD&D | Welfare Benefit Premiums Paid to Carrier | USD $135,574 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,913 | Amount paid for insurance broker fees | 9325 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 3 |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL36114 |
Policy instance | 8 |
Insurance contract or identification number | HCL36114 | Number of Individuals Covered | 215 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $603,230 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10096901001 |
Policy instance | 2 |
Insurance contract or identification number | 10096901001 | Number of Individuals Covered | 270 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,058 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,058 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 1 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 214 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $16,367 | Total amount of fees paid to insurance company | USD $1,350 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, CANCER, AD&D | Welfare Benefit Premiums Paid to Carrier | USD $134,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,367 | Amount paid for insurance broker fees | 1350 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0BK22 |
Policy instance | 6 |
Insurance contract or identification number | GVTL0BK22 | Number of Individuals Covered | 114 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $5,170 | Total amount of fees paid to insurance company | USD $1,792 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $25,849 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,170 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION PAID |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BK22 |
Policy instance | 3 |
Insurance contract or identification number | GLUG0BK22 | Number of Individuals Covered | 283 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $1,274 | Total amount of fees paid to insurance company | USD $390 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,493 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,274 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION PAID |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUC0BK22 |
Policy instance | 4 |
Insurance contract or identification number | GUC0BK22 | Number of Individuals Covered | 108 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $9,079 | Total amount of fees paid to insurance company | USD $2,597 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,079 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OTHER COMPENSATION PAID |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUPR0BK22 |
Policy instance | 5 |
Insurance contract or identification number | GUPR0BK22 | Number of Individuals Covered | 76 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $1,613 | Total amount of fees paid to insurance company | USD $2,042 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 2042 | Additional information about fees paid to insurance broker | OTHER COMPENSATION PAID | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10183511001 |
Policy instance | 7 |
Insurance contract or identification number | 10183511001 | Number of Individuals Covered | 1 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $18 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL36114 |
Policy instance | 8 |
Insurance contract or identification number | HCL36114 | Number of Individuals Covered | 197 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $480,453 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 3 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 194 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $10,798 | Total amount of fees paid to insurance company | USD $1,774 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $109,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,798 | Amount paid for insurance broker fees | 1054 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 2 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 183 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $5,531 | Total amount of fees paid to insurance company | USD $1,774 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,990 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,531 | Amount paid for insurance broker fees | 1054 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 1 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 50 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,109 | Total amount of fees paid to insurance company | USD $1,261 | Other welfare benefits provided | ACCIDENT, CANCER | Welfare Benefit Premiums Paid to Carrier | USD $20,144 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,109 | Amount paid for insurance broker fees | 1261 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10183511001 |
Policy instance | 9 |
Insurance contract or identification number | 10183511001 | Number of Individuals Covered | 2 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $11 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $88 | 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 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10096901001 |
Policy instance | 4 |
Insurance contract or identification number | 10096901001 | Number of Individuals Covered | 257 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,825 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,220 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,825 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0BK22 |
Policy instance | 5 |
Insurance contract or identification number | GLUG0BK22 | Number of Individuals Covered | 274 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $976 | Total amount of fees paid to insurance company | USD $321 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $976 | Amount paid for insurance broker fees | 321 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUC0BK22 |
Policy instance | 6 |
Insurance contract or identification number | GUC0BK22 | Number of Individuals Covered | 103 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $8,656 | Total amount of fees paid to insurance company | USD $1,991 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,278 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,656 | Amount paid for insurance broker fees | 1991 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUPR0BK22 |
Policy instance | 7 |
Insurance contract or identification number | GUPR0BK22 | Number of Individuals Covered | 83 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $1,702 | Total amount of fees paid to insurance company | USD $1,616 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,042 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,702 | Amount paid for insurance broker fees | 1616 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0BK22 |
Policy instance | 8 |
Insurance contract or identification number | GVTL0BK22 | Number of Individuals Covered | 105 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $5,974 | Total amount of fees paid to insurance company | USD $1,392 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $29,870 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,974 | Amount paid for insurance broker fees | 1392 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 1 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 61 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,243 | Total amount of fees paid to insurance company | USD $1,023 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, AD&D, CANCER | Welfare Benefit Premiums Paid to Carrier | USD $20,668 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,243 | Amount paid for insurance broker fees | 1023 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 2 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 243 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $63,121 | Total amount of fees paid to insurance company | USD $3,492 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $503,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63,121 | Amount paid for insurance broker fees | 3492 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10096901001 |
Policy instance | 4 |
Insurance contract or identification number | 10096901001 | Number of Individuals Covered | 254 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,717 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,717 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 3 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 207 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $11,292 | Total amount of fees paid to insurance company | USD $608 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,292 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10096901001 |
Policy instance | 5 |
Insurance contract or identification number | 10096901001 | Number of Individuals Covered | 204 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,570 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,570 | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 4 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 174 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $9,972 | Total amount of fees paid to insurance company | USD $534 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $101,269 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,972 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 534 | Additional information about fees paid to insurance broker | GENERAL AGENT PAYMENTS |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 3 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 215 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $68,338 | Total amount of fees paid to insurance company | USD $534 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $640,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,338 | Amount paid for insurance broker fees | 534 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 2 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 235 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $7,242 | Total amount of fees paid to insurance company | USD $2,423 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, AD&D, CANCER | Welfare Benefit Premiums Paid to Carrier | USD $47,322 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,242 | Amount paid for insurance broker fees | 2423 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 4 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 1 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 154 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $5,776 | Total amount of fees paid to insurance company | USD $768 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,453 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,776 | Amount paid for insurance broker fees | 768 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00613071 |
Policy instance | 6 |
Insurance contract or identification number | 00613071 | Number of Individuals Covered | 141 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $43,991 | Total amount of fees paid to insurance company | USD $1,416 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $397,269 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,991 | Amount paid for insurance broker fees | 1416 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00522807 |
Policy instance | 5 |
Insurance contract or identification number | 00522807 | Number of Individuals Covered | 243 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $9,883 | Total amount of fees paid to insurance company | USD $6,090 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, AD&D, CANCER | Welfare Benefit Premiums Paid to Carrier | USD $139,736 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,883 | Amount paid for insurance broker fees | 6090 | Additional information about fees paid to insurance broker | FEES PAID | Insurance broker organization code? | 4 | Insurance broker name | BROWN & BROWN OF FLORIDA |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676777 |
Policy instance | 4 |
Insurance contract or identification number | 676777 | Number of Individuals Covered | 5 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,876 | Total amount of fees paid to insurance company | USD $360 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,876 | Amount paid for insurance broker fees | 360 | Additional information about fees paid to insurance broker | BONUS PAID | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676705 |
Policy instance | 3 |
Insurance contract or identification number | 676705 | Number of Individuals Covered | 55 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $14,712 | Total amount of fees paid to insurance company | USD $3,048 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $360,272 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,712 | Amount paid for insurance broker fees | 3048 | Additional information about fees paid to insurance broker | BONUS PAID | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676744 |
Policy instance | 2 |
Insurance contract or identification number | 676744 | Number of Individuals Covered | 21 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,612 | Total amount of fees paid to insurance company | USD $768 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $103,787 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,612 | Amount paid for insurance broker fees | 768 | Additional information about fees paid to insurance broker | BONUS PAID | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 1 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 77 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $4,865 | Total amount of fees paid to insurance company | USD $509 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,763 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,865 | Amount paid for insurance broker fees | 509 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FL INC |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50016891 |
Policy instance | 7 |
Insurance contract or identification number | 50016891 | Number of Individuals Covered | 328 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,378 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $19,179 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,105 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 077557 |
Policy instance | 6 |
Insurance contract or identification number | 077557 | Number of Individuals Covered | 198 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $259 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $160 | Insurance broker name | MOSAIC GROUP |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676744 |
Policy instance | 5 |
Insurance contract or identification number | 676744 | Number of Individuals Covered | 16 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,108 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,108 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 19812 |
Policy instance | 4 |
Insurance contract or identification number | 19812 | Number of Individuals Covered | 34 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,706 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,899 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,361 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 3 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 127 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $3,046 | Total amount of fees paid to insurance company | USD $185 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,716 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,046 | Amount paid for insurance broker fees | 185 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9950783 |
Policy instance | 2 |
Insurance contract or identification number | 9950783 | Number of Individuals Covered | 185 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,035 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,431 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,035 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 ) |
Policy contract number | 865 |
Policy instance | 1 |
Insurance contract or identification number | 865 | Number of Individuals Covered | 210 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $5,809 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,809 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676705 |
Policy instance | 8 |
Insurance contract or identification number | 676705 | Number of Individuals Covered | 43 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $7,840 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $207,375 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,840 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 676777 |
Policy instance | 9 |
Insurance contract or identification number | 676777 | Number of Individuals Covered | 8 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $52,064 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,064 | Insurance broker organization code? | 3 | Insurance broker name | BROWN & BROWN OF FLORIDA INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 3 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 117 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,843 | Total amount of fees paid to insurance company | USD $163 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,755 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,843 | Amount paid for insurance broker fees | 163 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 19812 |
Policy instance | 4 |
Insurance contract or identification number | 19812 | Number of Individuals Covered | 37 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $10,575 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,288 | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY INC |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 077557 |
Policy instance | 1 |
Insurance contract or identification number | 077557 | Number of Individuals Covered | 124 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,204 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,204 | Insurance broker organization code? | 3 | Insurance broker name | JEFFREY W. PATTEN |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30006318 |
Policy instance | 2 |
Insurance contract or identification number | 30006318 | Number of Individuals Covered | 94 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $936 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $936 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 077557 |
Policy instance | 1 |
Insurance contract or identification number | 077557 | Number of Individuals Covered | 119 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $5,508 | Total amount of fees paid to insurance company | USD $5,000 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $608,244 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,508 | Amount paid for insurance broker fees | 5000 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | JEFFREY W. PATTEN |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 3 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 60 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,968 | Total amount of fees paid to insurance company | USD $868 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,149 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,968 | Amount paid for insurance broker fees | 174 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30006318 |
Policy instance | 2 |
Insurance contract or identification number | 30006318 | Number of Individuals Covered | 88 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $848 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,760 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $848 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 4 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 60 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,834 | Total amount of fees paid to insurance company | USD $820 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,878 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,834 | Amount paid for insurance broker fees | 164 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00454854 |
Policy instance | 3 |
Insurance contract or identification number | 00454854 | Number of Individuals Covered | 134 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $8,241 | Total amount of fees paid to insurance company | USD $3,061 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $75,351 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,049 | Amount paid for insurance broker fees | 3061 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30006318 |
Policy instance | 2 |
Insurance contract or identification number | 30006318 | Number of Individuals Covered | 83 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $796 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $796 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 606330 |
Policy instance | 1 |
Insurance contract or identification number | 606330 | Number of Individuals Covered | 102 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,067 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $195,354 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,067 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 4 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 58 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $2,476 | Total amount of fees paid to insurance company | USD $808 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,002 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30006318 |
Policy instance | 2 |
Insurance contract or identification number | 30006318 | Number of Individuals Covered | 83 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $767 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,483 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00454854 |
Policy instance | 3 |
Insurance contract or identification number | 00454854 | Number of Individuals Covered | 123 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $6,704 | Total amount of fees paid to insurance company | USD $3,175 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $61,661 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 606330 |
Policy instance | 1 |
Insurance contract or identification number | 606330 | Number of Individuals Covered | 103 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $7,067 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 400807 |
Policy instance | 4 |
Insurance contract or identification number | 400807 | Number of Individuals Covered | 53 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $2,815 | Total amount of fees paid to insurance company | USD $924 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,815 | Amount paid for insurance broker fees | 272 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00454854 |
Policy instance | 3 |
Insurance contract or identification number | 00454854 | Number of Individuals Covered | 103 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $7,080 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $63,708 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,669 | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30006318 |
Policy instance | 2 |
Insurance contract or identification number | 30006318 | Number of Individuals Covered | 67 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $782 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,900 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $782 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0713570 |
Policy instance | 1 |
Insurance contract or identification number | 0713570 | Number of Individuals Covered | 121 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,755 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $462,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,755 | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY, INC |
|