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EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 401k Plan overview

Plan NameEXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN
Plan identification number 503

EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

EXPRESSJET AIRLINES, LLC has sponsored the creation of one or more 401k plans.

Company Name:EXPRESSJET AIRLINES, LLC
Employer identification number (EIN):581354495
NAIC Classification:481000
NAIC Description: Air Transportation

Additional information about EXPRESSJET AIRLINES, LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date: 2012-01-04
Company Identification Number: 1684671
Legal Registered Office Address: 100 HartsField Centre Pkwy.
#700
ATLANTA
United States of America (USA)
30354

More information about EXPRESSJET AIRLINES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-01-01
5032018-01-01KEVIN WADE
5032017-01-01ROBERT SIMMONS
5032016-01-01ROBERT SIMMONS
5032015-01-01ROBERT SIMMONS
5032014-01-01ROBERT SIMMONS
5032013-01-01MICHAEL KRAUPP
5032012-01-01MICHAEL KRAUPP
5032011-01-01MICHAEL KRAUPP
5032010-01-01MICHAEL KRAUPP
5032009-01-01MICHAEL KRAUPP
5032009-01-01 MICHAEL KRAUPP2010-04-29

Plan Statistics for EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN

401k plan membership statisitcs for EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN

Measure Date Value
2019: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01380
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
2018: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01380
Total number of active participants reported on line 7a of the Form 55002018-01-01188
Total of all active and inactive participants2018-01-01188
Total participants2018-01-01188
2017: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01523
Total number of active participants reported on line 7a of the Form 55002017-01-01380
Total of all active and inactive participants2017-01-01380
Total participants2017-01-01380
2016: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01648
Total number of active participants reported on line 7a of the Form 55002016-01-01523
Total of all active and inactive participants2016-01-01523
Total participants2016-01-01523
2015: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01758
Total number of active participants reported on line 7a of the Form 55002015-01-01648
Total of all active and inactive participants2015-01-01648
Total participants2015-01-01648
2014: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01813
Total number of active participants reported on line 7a of the Form 55002014-01-01758
Total of all active and inactive participants2014-01-01758
Total participants2014-01-01758
2013: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01826
Total number of active participants reported on line 7a of the Form 55002013-01-01813
Total of all active and inactive participants2013-01-01813
Total participants2013-01-01813
2012: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01833
Total number of active participants reported on line 7a of the Form 55002012-01-01826
Total of all active and inactive participants2012-01-01826
Total participants2012-01-01826
2011: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01843
Total number of active participants reported on line 7a of the Form 55002011-01-01833
Total of all active and inactive participants2011-01-01833
Total participants2011-01-01833
2010: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,087
Total number of active participants reported on line 7a of the Form 55002010-01-01843
Total of all active and inactive participants2010-01-01843
Total participants2010-01-01843
2009: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,088
Total number of active participants reported on line 7a of the Form 55002009-01-011,087
Total of all active and inactive participants2009-01-011,087
Total participants2009-01-011,087

Form 5500 Responses for EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN

2019: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: EXPRESSJET AIRLINES, INC. PILOTS LOSS OF LICENSE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered188
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $830
Total amount of fees paid to insurance companyUSD $2,151
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $8,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2151
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $830
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered188
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $14,343
Total amount of fees paid to insurance companyUSD $4,933
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $143,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4933
Additional information about fees paid to insurance brokerBONUS PAID
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $14,343
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered380
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,665
Total amount of fees paid to insurance companyUSD $730
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $246,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees730
Additional information about fees paid to insurance brokerBONUS PAID
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $24,665
Insurance broker nameGBS BENEFITS INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered648
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $25,425
Total amount of fees paid to insurance companyUSD $3,081
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $250,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,425
Insurance broker organization code?3
Amount paid for insurance broker fees3081
Additional information about fees paid to insurance brokerNON-CONTINGENT COMPENSATION
Insurance broker nameMERCER HUMAN RESOURCE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered758
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,498
Total amount of fees paid to insurance companyUSD $-1,329
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $198,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,498
Insurance broker organization code?3
Amount paid for insurance broker fees-1329
Additional information about fees paid to insurance brokerNON-CONTINGENT COMPENSATION
Insurance broker nameMERCER HUMAN RESOURCE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered813
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $17,631
Total amount of fees paid to insurance companyUSD $950
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPILOTS LOSS OF LICENSE
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 CarrierUSD $176,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,631
Insurance broker organization code?3
Amount paid for insurance broker fees950
Additional information about fees paid to insurance brokerNON-CONTINGENT COMPENSATION
Insurance broker nameMERCER HUMAN RESOURCE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered826
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $18,230
Total amount of fees paid to insurance companyUSD $3,291
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPILOT'S LOSS OF LICENSE
Welfare Benefit Premiums Paid to CarrierUSD $182,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,230
Insurance broker organization code?3
Amount paid for insurance broker fees3291
Additional information about fees paid to insurance brokerNON-CONTINGENT COMPENSATION
Insurance broker nameMERCER HUMAN RESOURCE
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered833
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17,816
Total amount of fees paid to insurance companyUSD $6,050
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPILOT'S LOSS OF LICENSE
Welfare Benefit Premiums Paid to CarrierUSD $178,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675696G
Policy instance 1
Insurance contract or identification number675696G
Number of Individuals Covered843
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $19,564
Total amount of fees paid to insurance companyUSD $1,930
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPILOT'S LOSS OF LICENSE
Welfare Benefit Premiums Paid to CarrierUSD $195,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,564
Insurance broker organization code?3
Amount paid for insurance broker fees1930
Additional information about fees paid to insurance brokerNON-CONTINGENT COMPENSATION
Insurance broker nameMERCER HUMAN RESOURCE

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