CBL STATE SAVINGS BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST
401k plan membership statisitcs for SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST
Measure | Date | Value |
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2022: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 15 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 17 |
Total of all active and inactive participants | 2022-01-01 | 17 |
2021: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 11 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 15 |
Total of all active and inactive participants | 2021-01-01 | 15 |
2020: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 11 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 11 |
Total of all active and inactive participants | 2020-01-01 | 11 |
2019: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 11 |
Total of all active and inactive participants | 2019-01-01 | 11 |
2018: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 11 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 10 |
Total of all active and inactive participants | 2018-01-01 | 10 |
2017: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 12 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 11 |
Total of all active and inactive participants | 2017-01-01 | 11 |
2016: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 12 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 12 |
Total of all active and inactive participants | 2016-01-01 | 12 |
Total participants | 2016-01-01 | 12 |
2015: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 12 |
Total of all active and inactive participants | 2015-01-01 | 12 |
Total participants | 2015-01-01 | 12 |
2014: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 10 |
Total of all active and inactive participants | 2014-01-01 | 10 |
2013: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 8 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 8 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 8 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
Total participants | 2013-01-01 | 8 |
Number of participants with account balances | 2013-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
2012: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 8 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 8 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
Total participants | 2012-01-01 | 8 |
Number of participants with account balances | 2012-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
2011: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 10 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 10 |
Total participants | 2011-01-01 | 10 |
2010: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2010 401k membership |
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Total participants, beginning-of-year | 2010-01-01 | 10 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 10 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
Total of all active and inactive participants | 2010-01-01 | 10 |
Total participants | 2010-01-01 | 10 |
Measure | Date | Value |
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2022 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2022 401k financial data |
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Total income from all sources | 2022-12-31 | $174,434 |
Expenses. Total of all expenses incurred | 2022-12-31 | $174,434 |
Benefits paid (including direct rollovers) | 2022-12-31 | $162,071 |
Total contributions received or receivable from participants | 2022-12-31 | $43,474 |
Net income (gross income less expenses) | 2022-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2022-12-31 | $130,960 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $12,363 |
2021 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2021 401k financial data |
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Total income from all sources | 2021-12-31 | $133,696 |
Expenses. Total of all expenses incurred | 2021-12-31 | $133,696 |
Benefits paid (including direct rollovers) | 2021-12-31 | $124,254 |
Total contributions received or receivable from participants | 2021-12-31 | $41,032 |
Net income (gross income less expenses) | 2021-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2021-12-31 | $92,664 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $9,442 |
2020 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2020 401k financial data |
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Total income from all sources | 2020-12-31 | $137,754 |
Expenses. Total of all expenses incurred | 2020-12-31 | $137,754 |
Benefits paid (including direct rollovers) | 2020-12-31 | $128,241 |
Total contributions received or receivable from participants | 2020-12-31 | $46,944 |
Net income (gross income less expenses) | 2020-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2020-12-31 | $90,810 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $9,513 |
2019 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2019 401k financial data |
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Total income from all sources | 2019-12-31 | $170,556 |
Expenses. Total of all expenses incurred | 2019-12-31 | $170,556 |
Benefits paid (including direct rollovers) | 2019-12-31 | $162,940 |
Total contributions received or receivable from participants | 2019-12-31 | $39,300 |
Net income (gross income less expenses) | 2019-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2019-12-31 | $131,256 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $7,616 |
2018 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2018 401k financial data |
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Total income from all sources | 2018-12-31 | $183,561 |
Expenses. Total of all expenses incurred | 2018-12-31 | $183,561 |
Benefits paid (including direct rollovers) | 2018-12-31 | $139,101 |
Total contributions received or receivable from participants | 2018-12-31 | $73,424 |
Net income (gross income less expenses) | 2018-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2018-12-31 | $110,137 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $44,460 |
2017 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2017 401k financial data |
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Total income from all sources | 2017-12-31 | $162,834 |
Expenses. Total of all expenses incurred | 2017-12-31 | $162,834 |
Benefits paid (including direct rollovers) | 2017-12-31 | $155,317 |
Total contributions received or receivable from participants | 2017-12-31 | $36,814 |
Net income (gross income less expenses) | 2017-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2017-12-31 | $126,020 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $7,517 |
2016 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2016 401k financial data |
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Total income from all sources | 2016-12-31 | $147,482 |
Expenses. Total of all expenses incurred | 2016-12-31 | $147,482 |
Benefits paid (including direct rollovers) | 2016-12-31 | $132,057 |
Total contributions received or receivable from participants | 2016-12-31 | $2,079 |
Expenses. Other expenses not covered elsewhere | 2016-12-31 | $8,861 |
Net income (gross income less expenses) | 2016-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2016-12-31 | $145,403 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $6,564 |
2015 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2015 401k financial data |
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Total income from all sources | 2015-12-31 | $144,604 |
Expenses. Total of all expenses incurred | 2015-12-31 | $144,604 |
Benefits paid (including direct rollovers) | 2015-12-31 | $89,818 |
Total contributions received or receivable from participants | 2015-12-31 | $13,188 |
Expenses. Other expenses not covered elsewhere | 2015-12-31 | $46,837 |
Net income (gross income less expenses) | 2015-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2015-12-31 | $131,416 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $7,949 |
2014 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2014 401k financial data |
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Total income from all sources | 2014-12-31 | $128,732 |
Expenses. Total of all expenses incurred | 2014-12-31 | $128,732 |
Benefits paid (including direct rollovers) | 2014-12-31 | $100,749 |
Total contributions received or receivable from participants | 2014-12-31 | $13,328 |
Expenses. Other expenses not covered elsewhere | 2014-12-31 | $19,710 |
Net income (gross income less expenses) | 2014-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2014-12-31 | $115,404 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $8,273 |
2013 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2013 401k financial data |
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Total plan liabilities at end of year | 2013-12-31 | $0 |
Total plan liabilities at beginning of year | 2013-12-31 | $0 |
Total income from all sources | 2013-12-31 | $113,783 |
Expenses. Total of all expenses incurred | 2013-12-31 | $110,343 |
Benefits paid (including direct rollovers) | 2013-12-31 | $103,995 |
Total plan assets at end of year | 2013-12-31 | $0 |
Total plan assets at beginning of year | 2013-12-31 | $0 |
Total contributions received or receivable from participants | 2013-12-31 | $22,630 |
Expenses. Other expenses not covered elsewhere | 2013-12-31 | $3,440 |
Net income (gross income less expenses) | 2013-12-31 | $3,440 |
Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2013-12-31 | $91,153 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $6,348 |
2012 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2012 401k financial data |
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Total plan liabilities at end of year | 2012-12-31 | $0 |
Total plan liabilities at beginning of year | 2012-12-31 | $0 |
Total income from all sources | 2012-12-31 | $108,756 |
Expenses. Total of all expenses incurred | 2012-12-31 | $111,567 |
Benefits paid (including direct rollovers) | 2012-12-31 | $105,520 |
Total plan assets at end of year | 2012-12-31 | $0 |
Total plan assets at beginning of year | 2012-12-31 | $0 |
Total contributions received or receivable from participants | 2012-12-31 | $21,611 |
Net income (gross income less expenses) | 2012-12-31 | $-2,811 |
Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $0 |
Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $0 |
Total contributions received or receivable from employer(s) | 2012-12-31 | $87,145 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $6,047 |
2011 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2011 401k financial data |
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Total income from all sources | 2011-12-31 | $121,388 |
Expenses. Total of all expenses incurred | 2011-12-31 | $70,617 |
Benefits paid (including direct rollovers) | 2011-12-31 | $64,042 |
Total contributions received or receivable from participants | 2011-12-31 | $0 |
Expenses. Other expenses not covered elsewhere | 2011-12-31 | $0 |
Other income received | 2011-12-31 | $0 |
Net income (gross income less expenses) | 2011-12-31 | $50,771 |
Total contributions received or receivable from employer(s) | 2011-12-31 | $121,388 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $6,575 |
2010 : SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2010 401k financial data |
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Total income from all sources | 2010-12-31 | $141,242 |
Expenses. Total of all expenses incurred | 2010-12-31 | $69,323 |
Benefits paid (including direct rollovers) | 2010-12-31 | $64,662 |
Total contributions received or receivable from participants | 2010-12-31 | $0 |
Other income received | 2010-12-31 | $0 |
Net income (gross income less expenses) | 2010-12-31 | $71,919 |
Total contributions received or receivable from employer(s) | 2010-12-31 | $141,242 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $4,661 |
2022: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2010: SOUTH CAROLINA BANKERS EMPLOYEE BENEFIT TRUST 2010 form 5500 responses |
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2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Submission has been amended | Yes |
2010-01-01 | Plan funding arrangement – Insurance | Yes |
2010-01-01 | Plan benefit arrangement – Insurance | Yes |
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 71-85417-12 |
Policy instance | 4 |
Insurance contract or identification number | 71-85417-12 | Number of Individuals Covered | 17 | 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 | 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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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 22010061 |
Policy instance | 3 |
Insurance contract or identification number | 22010061 | Number of Individuals Covered | 31 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $139 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,054 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $111 | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 2 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,155 | Total amount of fees paid to insurance company | USD $506 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,856 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,155 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 506 | Additional information about fees paid to insurance broker | SERVICE FEE |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 1 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 53 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $846 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $564 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 1 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 43 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $905 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,752 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $603 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 2 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,133 | Total amount of fees paid to insurance company | USD $496 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,546 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,133 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SERVICE FEE |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 |
Policy instance | 3 |
Insurance contract or identification number | 30016141 | Number of Individuals Covered | 12 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $63 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 71-85417-12 |
Policy instance | 4 |
Insurance contract or identification number | 71-85417-12 | Number of Individuals Covered | 12 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 1 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 15 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $948 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,715 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $632 | Insurance broker organization code? | 3 |
|
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 2 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,926 | Total amount of fees paid to insurance company | USD $455 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $15,144 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,926 | Additional information about fees paid to insurance broker | SERVICE FEES | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 455 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 |
Policy instance | 3 |
Insurance contract or identification number | 30016141 | Number of Individuals Covered | 12 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $50 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 71-85417-12 |
Policy instance | 4 |
Insurance contract or identification number | 71-85417-12 | Number of Individuals Covered | 11 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 1 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 13 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $810 | 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 $470 | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 2 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,645 | Total amount of fees paid to insurance company | USD $396 | 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 $13,199 | 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 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 396 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 |
Policy instance | 3 |
Insurance contract or identification number | 30016141 | Number of Individuals Covered | 11 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $52 | Total amount of fees paid to insurance company | USD $0 | Vision 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 $52 |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 71-85417-12 |
Policy instance | 4 |
Insurance contract or identification number | 71-85417-12 | Number of Individuals Covered | 11 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-85418-12 |
Policy instance | 1 |
Insurance contract or identification number | 03-85418-12 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-85417 |
Policy instance | 2 |
Insurance contract or identification number | 03-85417 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-85419-12 |
Policy instance | 3 |
Insurance contract or identification number | 03-85419-12 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 4 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 33 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $714 | 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 $476 | Insurance broker organization code? | 3 |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 5 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $11,336 | Total amount of fees paid to insurance company | USD $311 | 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 $10,376 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,336 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 311 | Additional information about fees paid to insurance broker | SERVICE FEE |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 |
Policy instance | 6 |
Insurance contract or identification number | 30016141 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision 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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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4043923 |
Policy instance | 7 |
Insurance contract or identification number | E4043923 | Number of Individuals Covered | 11 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,733 | Total amount of fees paid to insurance company | USD $155 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $17,265 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,232 | Amount paid for insurance broker fees | 20 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | JENNIFER ARRINGTON |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 |
Policy instance | 6 |
Insurance contract or identification number | 30016141 | Number of Individuals Covered | 9 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision 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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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 5 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 33 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,400 | Total amount of fees paid to insurance company | USD $314 | 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 $10,467 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,400 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 314 | Additional information about fees paid to insurance broker | SERVICE FEES | Insurance broker name | THE BENEFIT COMPANY |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 4 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 11 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $633 | 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 $422 | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-85418 |
Policy instance | 3 |
Insurance contract or identification number | 03-85418 | Number of Individuals Covered | 1 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-85417 |
Policy instance | 2 |
Insurance contract or identification number | 03-85417 | Number of Individuals Covered | 8 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-51236 |
Policy instance | 1 |
Insurance contract or identification number | 03-51236 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-51236 |
Policy instance | 1 |
Insurance contract or identification number | 03-51236 | Number of Individuals Covered | 12 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 2 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 12 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $207 | Insurance broker organization code? | 3 | Insurance broker name | SCBA SERVICES, INC. |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141 0016 |
Policy instance | 4 |
Insurance contract or identification number | 30016141 0016 | Number of Individuals Covered | 5 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 3 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $59 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 89 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker name | THE BENEFIT COMPANY |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-51236 |
Policy instance | 1 |
Insurance contract or identification number | 03-51236 | Number of Individuals Covered | 11 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 61691000 |
Policy instance | 2 |
Insurance contract or identification number | 61691000 | Number of Individuals Covered | 11 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $558 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $372 | Insurance broker organization code? | 3 | Insurance broker name | THE BENEFIT COMPANY |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30016141-0016 |
Policy instance | 3 |
Insurance contract or identification number | 30016141-0016 | Number of Individuals Covered | 5 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision 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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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 68181-4 |
Policy instance | 4 |
Insurance contract or identification number | 68181-4 | Number of Individuals Covered | 10 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $290 | Total amount of fees paid to insurance company | USD $79 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $290 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 79 | Insurance broker name | THE BENEFIT COMPANY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05469906 |
Policy instance | 3 |
Insurance contract or identification number | TS05469906 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $305 | 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 $305 | Insurance broker organization code? | 3 | Insurance broker name | SC BANKERS EMPLOYEE BENEFIT TRUST |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03 51236 |
Policy instance | 1 |
Insurance contract or identification number | 03 51236 | Number of Individuals Covered | 11 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | 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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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30 016141 0016 |
Policy instance | 2 |
Insurance contract or identification number | 30 016141 0016 | Number of Individuals Covered | 3 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision 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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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30 016141 |
Policy instance | 2 |
Insurance contract or identification number | 30 016141 | Number of Individuals Covered | 3 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Unemployment 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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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03 51236 |
Policy instance | 1 |
Insurance contract or identification number | 03 51236 | Number of Individuals Covered | 8 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Health Insurance Welfare Benefit | Yes | Unemployment 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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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS054699906 |
Policy instance | 3 |
Insurance contract or identification number | TS054699906 | Number of Individuals Covered | 37 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $301 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Unemployment 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 $301 | Insurance broker name | S C BANKES EMPLOYEE BENEFIT TRUST |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-51236-97 |
Policy instance | 1 |
Insurance contract or identification number | 03-51236-97 | Number of Individuals Covered | 11 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Health Insurance Welfare Benefit | Yes |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TSO5469906 |
Policy instance | 2 |
Insurance contract or identification number | TSO5469906 | Number of Individuals Covered | 45 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $281 | Dental Insurance Welfare Benefit | Yes |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-51236-97 |
Policy instance | 1 |
Insurance contract or identification number | 03-51236-97 | Number of Individuals Covered | 10 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Health Insurance Welfare Benefit | Yes |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05469906 |
Policy instance | 3 |
Insurance contract or identification number | TS05469906 | Number of Individuals Covered | 41 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $319 | Dental Insurance Welfare Benefit | Yes | Commission paid to Insurance Broker | USD $319 | Insurance broker organization code? | 5 | Insurance broker name | S C BANKERS EMPLOYEE BENEFIT TRUST |
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BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
Policy contract number | 03-55075-50 |
Policy instance | 2 |
Insurance contract or identification number | 03-55075-50 | Number of Individuals Covered | 1 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Health Insurance Welfare Benefit | Yes |
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