EYE CONSULTANTS OF ATLANTA, PC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH
401k plan membership statisitcs for EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH
Measure | Date | Value |
---|
2022: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 279 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 286 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 286 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 269 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 279 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 279 |
2020: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 250 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 269 |
Total of all active and inactive participants | 2020-01-01 | 269 |
2019: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 260 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 250 |
Total of all active and inactive participants | 2019-01-01 | 250 |
2018: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 249 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 260 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 260 |
2017: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 228 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 221 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 222 |
2016: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 217 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 228 |
Total of all active and inactive participants | 2016-01-01 | 228 |
Total participants | 2016-01-01 | 228 |
Number of participants with account balances | 2016-01-01 | 228 |
2014: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 202 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 209 |
Total of all active and inactive participants | 2014-01-01 | 209 |
Total participants | 2014-01-01 | 209 |
2013: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 186 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 202 |
Total of all active and inactive participants | 2013-01-01 | 202 |
Total participants | 2013-01-01 | 202 |
2012: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 182 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 204 |
Total of all active and inactive participants | 2012-01-01 | 204 |
Total participants | 2012-01-01 | 204 |
2011: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 182 |
Total of all active and inactive participants | 2011-01-01 | 182 |
Total participants | 2011-01-01 | 182 |
2009: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 137 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 137 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
Total participants | 2009-01-01 | 137 |
2022: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2022 form 5500 responses |
---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2021 form 5500 responses |
---|
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | No |
2021-01-01 | This submission is the final filing | No |
2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-01-01 | Plan is a collectively bargained plan | No |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2020 form 5500 responses |
---|
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2019 form 5500 responses |
---|
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2018 form 5500 responses |
---|
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2017 form 5500 responses |
---|
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2016 form 5500 responses |
---|
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 funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2014 form 5500 responses |
---|
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2013 form 5500 responses |
---|
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2012 form 5500 responses |
---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2011 form 5500 responses |
---|
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | No |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: EYE CONSULTANTS OF ATLANTA, PC WELFARE PLAN - HEALTH 2009 form 5500 responses |
---|
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | First time form 5500 has been submitted | Yes |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | No |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0761106 |
Policy instance | 2 |
Insurance contract or identification number | R0761106 | Number of Individuals Covered | 286 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $53,049 | Total amount of fees paid to insurance company | USD $5,548 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, HOSPITAL,ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $271,467 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,966 | Amount paid for insurance broker fees | 5548 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5966953 |
Policy instance | 1 |
Insurance contract or identification number | 5966953 | Number of Individuals Covered | 387 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $23,404 | Total amount of fees paid to insurance company | USD $3,781 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $140,753 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,366 | Amount paid for insurance broker fees | 31 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01L5809 |
Policy instance | 1 |
Insurance contract or identification number | 01L5809 | Number of Individuals Covered | 24 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $8,735 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $172,372 | Commission paid to Insurance Broker | USD $8,735 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836868 |
Policy instance | 2 |
Insurance contract or identification number | 836868 | Number of Individuals Covered | 114 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $5,592 | Total amount of fees paid to insurance company | USD $1,496 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $43,549 | Commission paid to Insurance Broker | USD $5,592 | Amount paid for insurance broker fees | 1496 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5966953 |
Policy instance | 3 |
Insurance contract or identification number | 5966953 | Number of Individuals Covered | 394 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $18,953 | Total amount of fees paid to insurance company | USD $5,312 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,079 | Commission paid to Insurance Broker | USD $18,953 | Amount paid for insurance broker fees | 5312 | Additional information about fees paid to insurance broker | SERVICE FEES | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836867 |
Policy instance | 4 |
Insurance contract or identification number | 836867 | Number of Individuals Covered | 279 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $25,504 | Total amount of fees paid to insurance company | USD $4,760 | 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 $170,076 | Commission paid to Insurance Broker | USD $25,504 | Amount paid for insurance broker fees | 4760 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0761106 |
Policy instance | 5 |
Insurance contract or identification number | R0761106 | Number of Individuals Covered | 98 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,092 | Total amount of fees paid to insurance company | USD $261 | Other welfare benefits provided | CRITICAL ILLNESS, HOSPITAL, ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $15,436 | Commission paid to Insurance Broker | USD $1,920 | Amount paid for insurance broker fees | 1 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836869 |
Policy instance | 6 |
Insurance contract or identification number | 836869 | Number of Individuals Covered | 72 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $10,343 | Total amount of fees paid to insurance company | USD $2,981 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $82,731 | Commission paid to Insurance Broker | USD $10,343 | Amount paid for insurance broker fees | 2981 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
Policy contract number | EMC L20100292 |
Policy instance | 7 |
Insurance contract or identification number | EMC L20100292 | Number of Individuals Covered | 191 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $270,885 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836867 |
Policy instance | 7 |
Insurance contract or identification number | 836867 | Number of Individuals Covered | 269 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $22,891 | Total amount of fees paid to insurance company | USD $3,692 | 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 $139,715 | Commission paid to Insurance Broker | USD $22,891 | Amount paid for insurance broker fees | 3692 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5966953 |
Policy instance | 6 |
Insurance contract or identification number | 5966953 | Number of Individuals Covered | 418 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $14,491 | Total amount of fees paid to insurance company | USD $1,607 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $134,951 | Commission paid to Insurance Broker | USD $14,491 | Amount paid for insurance broker fees | 21 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
Policy contract number | A20115 |
Policy instance | 5 |
Insurance contract or identification number | A20115 | Number of Individuals Covered | 208 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $280,911 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836868 |
Policy instance | 4 |
Insurance contract or identification number | 836868 | Number of Individuals Covered | 118 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $5,144 | Total amount of fees paid to insurance company | USD $763 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,738 | Commission paid to Insurance Broker | USD $5,144 | Amount paid for insurance broker fees | 763 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 01L5809 |
Policy instance | 3 |
Insurance contract or identification number | 01L5809 | 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 $6,800 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $144,677 | Commission paid to Insurance Broker | USD $6,800 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836869 |
Policy instance | 2 |
Insurance contract or identification number | 836869 | Number of Individuals Covered | 74 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $9,312 | Total amount of fees paid to insurance company | USD $1,396 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,943 | Commission paid to Insurance Broker | USD $9,312 | Amount paid for insurance broker fees | 1396 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0761106 |
Policy instance | 1 |
Insurance contract or identification number | R0761106 | Number of Individuals Covered | 124 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT, HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $23,177 | Commission paid to Insurance Broker | USD $3,439 | Amount paid for insurance broker fees | 118 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0761106 |
Policy instance | 2 |
Insurance contract or identification number | R0761106 | Number of Individuals Covered | 98 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,322 | Total amount of fees paid to insurance company | USD $1,275 | Other welfare benefits provided | CRITICAL CARE, ACCIDENT, HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $21,485 | Commission paid to Insurance Broker | USD $4,322 | Amount paid for insurance broker fees | 1275 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | A47045 |
Policy instance | 3 |
Insurance contract or identification number | A47045 | Number of Individuals Covered | 14 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $6,229 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $180,460 | Commission paid to Insurance Broker | USD $924 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 345035 |
Policy instance | 4 |
Insurance contract or identification number | 345035 | Number of Individuals Covered | 167 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $11,385 | Total amount of fees paid to insurance company | USD $1,338 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,877 | Commission paid to Insurance Broker | USD $11,385 | Amount paid for insurance broker fees | 1338 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836868 |
Policy instance | 5 |
Insurance contract or identification number | 836868 | Number of Individuals Covered | 105 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,564 | Total amount of fees paid to insurance company | USD $729 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,649 | Commission paid to Insurance Broker | USD $3,830 | Amount paid for insurance broker fees | 484 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836869 |
Policy instance | 6 |
Insurance contract or identification number | 836869 | Number of Individuals Covered | 102 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $8,974 | Total amount of fees paid to insurance company | USD $1,450 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,300 | Commission paid to Insurance Broker | USD $7,438 | Amount paid for insurance broker fees | 938 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 836867 |
Policy instance | 7 |
Insurance contract or identification number | 836867 | Number of Individuals Covered | 250 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $19,282 | Total amount of fees paid to insurance company | USD $4,230 | 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 $141,442 | Commission paid to Insurance Broker | USD $10,986 | Amount paid for insurance broker fees | 1465 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00345035 |
Policy instance | 1 |
Insurance contract or identification number | 00345035 | Number of Individuals Covered | 260 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $39,978 | Total amount of fees paid to insurance company | USD $2,744 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D, ACCIDENT, VOLUNTARY CRITICAL ILLNESS, VOLUNTARY HOSPITAL INDEMNITY | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $288,878 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,978 | Amount paid for insurance broker fees | 2744 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00345035 |
Policy instance | 1 |
Insurance contract or identification number | 00345035 | Number of Individuals Covered | 249 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $24,587 | Total amount of fees paid to insurance company | USD $7,296 | Are there contracts with allocated funds for individual policies? | 0 | 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 | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $276,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,587 | Amount paid for insurance broker fees | 7296 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|