SAVANNAH COLLEGE OF ART AND DESIGN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN
401k plan membership statisitcs for SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN
| Measure | Date | Value |
|---|
| 2021: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 1,335 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 1,643 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 1,643 |
| 2019: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 2,437 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 1,396 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 1,396 |
| 2018: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 2,352 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 2,437 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 2,437 |
| 2017: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 2,282 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 2,352 |
| Total of all active and inactive participants | 2017-10-01 | 2,352 |
| 2016: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 2,277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 2,282 |
| Total of all active and inactive participants | 2016-10-01 | 2,282 |
| 2015: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 1,166 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 2,277 |
| Total of all active and inactive participants | 2015-10-01 | 2,277 |
| 2014: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 1,165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 1,166 |
| Total of all active and inactive participants | 2014-10-01 | 1,166 |
| 2013: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 1,272 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 1,165 |
| Total of all active and inactive participants | 2013-10-01 | 1,165 |
| 2012: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 1,259 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 1,272 |
| Total of all active and inactive participants | 2012-10-01 | 1,272 |
| 2011: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 1,386 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 1,259 |
| Total of all active and inactive participants | 2011-10-01 | 1,259 |
| 2010: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 1,485 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 1,386 |
| Total of all active and inactive participants | 2010-10-01 | 1,386 |
| 2009: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 1,398 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 1,485 |
| Total of all active and inactive participants | 2009-10-01 | 1,485 |
| Total participants | 2009-10-01 | 1,485 |
| 2007: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-10-01 | 1,196 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-10-01 | 1,216 |
| Total of all active and inactive participants | 2007-10-01 | 1,216 |
| Total participants | 2007-10-01 | 1,216 |
| 2021: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Submission has been amended | Yes |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: SAVANNAH COLLEGE OF ART AND DESIGN COMPREHENSIVE HEALTH AND WELFARE WRAP PLAN 2007 form 5500 responses |
|---|
| 2007-10-01 | Type of plan entity | Single employer plan |
| 2007-10-01 | Submission has been amended | No |
| 2007-10-01 | This submission is the final filing | No |
| 2007-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-10-01 | Plan is a collectively bargained plan | No |
| 2007-10-01 | Plan funding arrangement – Insurance | Yes |
| 2007-10-01 | Plan benefit arrangement – Insurance | Yes |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 417005411750 |
| Policy instance | 6 |
| Insurance contract or identification number | 417005411750 | | Number of Individuals Covered | 1406 | | Insurance policy end date | 2022-10-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $2,520,342 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 952740 |
| Policy instance | 5 |
| Insurance contract or identification number | 952740 | | Number of Individuals Covered | 14 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $12 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 941916 |
| Policy instance | 4 |
| Insurance contract or identification number | 941916 | | Number of Individuals Covered | 744 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $13,808 | | Welfare Benefit Premiums Paid to Carrier | USD $2,519,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 13808 | | Additional information about fees paid to insurance broker | BONUSES AND ADDITIONAL PAYMENTS PAID | | Insurance broker organization code? | 3 |
|
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 941799 |
| Policy instance | 3 |
| Insurance contract or identification number | 941799 | | Number of Individuals Covered | 2 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NY DISABILITY, PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $833 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 941798 |
| Policy instance | 2 |
| Insurance contract or identification number | 941798 | | Number of Individuals Covered | 1911 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $72,488 | | Total amount of fees paid to insurance company | USD $1,482 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,650,831 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $72,488 | | Amount paid for insurance broker fees | 1482 | | Additional information about fees paid to insurance broker | BONUSES AND ADDITIONAL PAYMENTS PAID | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 942546 |
| Policy instance | 1 |
| Insurance contract or identification number | 942546 | | Number of Individuals Covered | 359 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $26,038 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $222,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,038 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA385029086301 |
| Policy instance | 2 |
| Insurance contract or identification number | SA385029086301 | | Number of Individuals Covered | 1654 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $74,344 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $369,219 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $74,344 | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD385029086302 |
| Policy instance | 3 |
| Insurance contract or identification number | PD385029086302 | | Number of Individuals Covered | 1626 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Other welfare benefits provided | LIBERTY MUTUTAL LEAVE SERVICES | | Welfare Benefit Premiums Paid to Carrier | USD $62,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION OTHERS | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF385029086301 |
| Policy instance | 4 |
| Insurance contract or identification number | GF385029086301 | | Number of Individuals Covered | 1630 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $56,917 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $300,740 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,917 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0142756 |
| Policy instance | 5 |
| Insurance contract or identification number | 0142756 | | Number of Individuals Covered | 2621 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $46,098 | | Total amount of fees paid to insurance company | USD $1,923 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $964,771 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,098 | | Amount paid for insurance broker fees | 32 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 98843211001 |
| Policy instance | 6 |
| Insurance contract or identification number | 98843211001 | | Number of Individuals Covered | 2005 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $7,425 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $133,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,425 | | Insurance broker organization code? | 3 |
|
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | 417004411750 |
| Policy instance | 7 |
| Insurance contract or identification number | 417004411750 | | Number of Individuals Covered | 1414 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Welfare Benefit Premiums Paid to Carrier | USD $1,787,572 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 621424 |
| Policy instance | 1 |
| Insurance contract or identification number | 621424 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | LONGTERM CARE | | Welfare Benefit Premiums Paid to Carrier | USD $18,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF385029086301 |
| Policy instance | 1 |
| Insurance contract or identification number | GF385029086301 | | Number of Individuals Covered | 1556 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $26,384 | | Total amount of fees paid to insurance company | USD $2,241 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $236,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,366 | | Amount paid for insurance broker fees | 2241 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA385029086301 |
| Policy instance | 7 |
| Insurance contract or identification number | SA385029086301 | | Number of Individuals Covered | 1632 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $58,487 | | Total amount of fees paid to insurance company | USD $3,844 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $393,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,480 | | Amount paid for insurance broker fees | 3844 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0142756 |
| Policy instance | 3 |
| Insurance contract or identification number | 0142756 | | Number of Individuals Covered | 2437 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $27,059 | | Total amount of fees paid to insurance company | USD $791 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $932,214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,696 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 791 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL & NON-MONETARY COMP |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GS385029086301 |
| Policy instance | 2 |
| Insurance contract or identification number | GS385029086301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $14 | | Temporary 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 $14 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 98843211001 |
| Policy instance | 4 |
| Insurance contract or identification number | 98843211001 | | Number of Individuals Covered | 1827 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $7,929 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $143,477 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,460 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 621424 |
| Policy instance | 5 |
| Insurance contract or identification number | 621424 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Other welfare benefits provided | LONGTERM CARE | | Welfare Benefit Premiums Paid to Carrier | USD $20,174 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) |
| Policy contract number | 417004411750 |
| Policy instance | 6 |
| Insurance contract or identification number | 417004411750 | | Number of Individuals Covered | 1358 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Welfare Benefit Premiums Paid to Carrier | USD $1,072,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA385029086301 |
| Policy instance | 6 |
| Insurance contract or identification number | SA385029086301 | | Number of Individuals Covered | 1612 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $51,250 | | Total amount of fees paid to insurance company | USD $7,681 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $386,278 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 621424 |
| Policy instance | 1 |
| Insurance contract or identification number | 621424 | | Number of Individuals Covered | 22 | | 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 | | Other welfare benefits provided | LONGTERM CARE | | Welfare Benefit Premiums Paid to Carrier | USD $21,223 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | 417003411750 |
| Policy instance | 3 |
| Insurance contract or identification number | 417003411750 | | Number of Individuals Covered | 1285 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-10-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,170,131 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0142756 |
| Policy instance | 2 |
| Insurance contract or identification number | 0142756 | | Number of Individuals Covered | 2352 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $45,310 | | Total amount of fees paid to insurance company | USD $6,162 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $908,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
| Policy contract number | 98843211001 |
| Policy instance | 4 |
| Insurance contract or identification number | 98843211001 | | Number of Individuals Covered | 1680 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $6,432 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $136,594 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GS385029086301 |
| Policy instance | 5 |
| Insurance contract or identification number | GS385029086301 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $14 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF385029086301 |
| Policy instance | 7 |
| Insurance contract or identification number | GF385029086301 | | Number of Individuals Covered | 1528 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $30,852 | | Total amount of fees paid to insurance company | USD $4,411 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $223,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
