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JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameJIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN
Plan identification number 501

JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

JIM ELLIS ATLANTA, INC. has sponsored the creation of one or more 401k plans.

Company Name:JIM ELLIS ATLANTA, INC.
Employer identification number (EIN):581500444
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01BROOKE GATLIN2023-06-12
5012021-01-01JAMES E. ELLIS2022-05-20
5012020-11-01JAMES E. ELLIS2021-05-19
5012019-11-01JAMES E. ELLIS2021-05-19
5012018-11-01JAMES E. ELLIS2020-04-24
5012017-11-01JAMES E. ELLIS2019-04-23
5012016-11-01
5012016-08-01
5012015-08-01
5012014-08-01
5012013-08-01
5012012-08-01JAMES E. ELLIS
5012011-08-01JAMES E. ELLIS
5012009-08-01JAMES E. ELLIS

Plan Statistics for JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN

Measure Date Value
2022: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,613
Total number of active participants reported on line 7a of the Form 55002022-01-011,665
Total of all active and inactive participants2022-01-011,665
2021: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,315
Total number of active participants reported on line 7a of the Form 55002021-01-011,613
Total of all active and inactive participants2021-01-011,613
2020: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-011,303
Total number of active participants reported on line 7a of the Form 55002020-11-011,315
Total of all active and inactive participants2020-11-011,315
2019: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-011,407
Total number of active participants reported on line 7a of the Form 55002019-11-011,303
Total of all active and inactive participants2019-11-011,303
2018: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-011,298
Total number of active participants reported on line 7a of the Form 55002018-11-011,407
Total of all active and inactive participants2018-11-011,407
2017: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-011,025
Total number of active participants reported on line 7a of the Form 55002017-11-011,298
Total of all active and inactive participants2017-11-011,298
2016: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-010
Total number of active participants reported on line 7a of the Form 55002016-11-011,025
Total of all active and inactive participants2016-11-011,025
Total participants, beginning-of-year2016-08-01657
Total number of active participants reported on line 7a of the Form 55002016-08-010
Total of all active and inactive participants2016-08-010
2015: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01597
Total number of active participants reported on line 7a of the Form 55002015-08-01657
Total of all active and inactive participants2015-08-01657
2014: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01443
Total number of active participants reported on line 7a of the Form 55002014-08-01597
Total of all active and inactive participants2014-08-01597
2013: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01383
Total number of active participants reported on line 7a of the Form 55002013-08-01443
Total of all active and inactive participants2013-08-01443
2012: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01383
Total number of active participants reported on line 7a of the Form 55002012-08-01383
Total of all active and inactive participants2012-08-01383
2011: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01325
Total number of active participants reported on line 7a of the Form 55002011-08-01366
Total of all active and inactive participants2011-08-01366
2009: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01410
Total number of active participants reported on line 7a of the Form 55002009-08-01331
Total of all active and inactive participants2009-08-01331

Form 5500 Responses for JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN

2022: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan funding arrangement – General assets of the sponsorYes
2020-11-01Plan benefit arrangement – InsuranceYes
2020-11-01Plan benefit arrangement – General assets of the sponsorYes
2019: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – General assets of the sponsorYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – General assets of the sponsorYes
2018: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – General assets of the sponsorYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – General assets of the sponsorYes
2017: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – General assets of the sponsorYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – General assets of the sponsorYes
2016: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01First time form 5500 has been submittedYes
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – General assets of the sponsorYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – General assets of the sponsorYes
2016-08-01Type of plan entitySingle employer plan
2016-08-01This submission is the final filingYes
2016-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan funding arrangement – General assets of the sponsorYes
2016-08-01Plan benefit arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – General assets of the sponsorYes
2015: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – General assets of the sponsorYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – General assets of the sponsorYes
2014: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: JIM ELLIS ATLANTA, INC. FLEXIBLE BENEFITS PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01This submission is the final filingNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – General assets of the sponsorYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0526
Policy instance 2
Insurance contract or identification numberGB0526
Number of Individuals Covered1492
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $65,191
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $648,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,191
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered754
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $28,323
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $141,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,323
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Number of Individuals Covered1665
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $77,454
Total amount of fees paid to insurance companyUSD $4,165
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $434,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $77,454
Amount paid for insurance broker fees4165
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Number of Individuals Covered1613
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $93,712
Total amount of fees paid to insurance companyUSD $4,126
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $482,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $93,712
Amount paid for insurance broker fees4126
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0526
Policy instance 2
Insurance contract or identification numberGB0526
Number of Individuals Covered1385
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $77,936
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,023,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $77,936
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered698
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $25,014
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $125,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,014
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0526
Policy instance 2
Insurance contract or identification numberGB0526
Number of Individuals Covered1204
Insurance policy start date2020-11-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $47,302
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $427,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,302
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered784
Insurance policy start date2020-11-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,870
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $19,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,870
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Number of Individuals Covered1315
Insurance policy start date2020-11-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,286
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,286
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered798
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $23,809
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $119,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,809
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGB0526
Policy instance 2
Insurance contract or identification numberGB0526
Number of Individuals Covered1221
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $269,388
Total amount of fees paid to insurance companyUSD $9,314
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,803,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $219,773
Amount paid for insurance broker fees9314
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Number of Individuals Covered1303
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $78,412
Total amount of fees paid to insurance companyUSD $5,716
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $335,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,412
Amount paid for insurance broker fees5716
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0906383
Policy instance 2
Insurance contract or identification number0906383
Number of Individuals Covered1407
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $57,597
Total amount of fees paid to insurance companyUSD $238,905
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,196,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,597
Amount paid for insurance broker fees238905
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered1201
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $21,585
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $107,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,585
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $73,055
Total amount of fees paid to insurance companyUSD $13,927
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $369,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,055
Amount paid for insurance broker fees13927
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA1943
Policy instance 3
Insurance contract or identification numberGA1943
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $35,173
Total amount of fees paid to insurance companyUSD $5,652
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $288,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0906383
Policy instance 2
Insurance contract or identification number0906383
Number of Individuals Covered1298
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $52,638
Total amount of fees paid to insurance companyUSD $211,131
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,608,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70271-4
Policy instance 1
Insurance contract or identification number70271-4
Number of Individuals Covered655
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $20,577
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D AND CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $93,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number8705
Policy instance 4
Insurance contract or identification number8705
Number of Individuals Covered758
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $16,338
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $46,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,266
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05995256
Policy instance 3
Insurance contract or identification numberTM05995256
Number of Individuals Covered814
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $26,549
Total amount of fees paid to insurance companyUSD $6,432
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $390,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,549
Additional information about fees paid to insurance brokerBASE COMMISSIONS
Insurance broker organization code?3
Amount paid for insurance broker fees6432
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered656
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $92,633
Total amount of fees paid to insurance companyUSD $960
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $92,633
Amount paid for insurance broker fees960
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 5
Insurance contract or identification number1016694000
Number of Individuals Covered520
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $936
Total amount of fees paid to insurance companyUSD $10
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $936
Amount paid for insurance broker fees10
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 2
Insurance contract or identification number1016694000
Number of Individuals Covered1
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker name
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered450
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $78,359
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,359
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 2
Insurance contract or identification number1016694000
Number of Individuals Covered1
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $157
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $157
Insurance broker organization code?3
Insurance broker name
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number8705
Policy instance 4
Insurance contract or identification number8705
Number of Individuals Covered630
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $8,354
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $34,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,272
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05995256
Policy instance 3
Insurance contract or identification numberTM05995256
Number of Individuals Covered734
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $20,905
Total amount of fees paid to insurance companyUSD $6,687
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $254,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,905
Additional information about fees paid to insurance brokerBASE COMMISSIONS
Insurance broker organization code?3
Amount paid for insurance broker fees6687
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 2
Insurance contract or identification number1016694000
Number of Individuals Covered27
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $4,105
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,105
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered401
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $64,306
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,306
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05995256
Policy instance 3
Insurance contract or identification numberTM05995256
Number of Individuals Covered698
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $15,799
Total amount of fees paid to insurance companyUSD $12,227
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $270,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,799
Additional information about fees paid to insurance brokerBASE COMMISSIONS
Insurance broker organization code?3
Amount paid for insurance broker fees12227
Insurance broker nameJ. SMITH LANIER & CO.
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number8705
Policy instance 4
Insurance contract or identification number8705
Number of Individuals Covered630
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $17,287
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $43,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,959
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number8705
Policy instance 5
Insurance contract or identification number8705
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $4,307
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $21,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,228
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO
AMERICAN GENERAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68373 )
Policy contract numberV588705
Policy instance 4
Insurance contract or identification numberV588705
Number of Individuals Covered376
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $9,173
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $45,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,173
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 3
Insurance contract or identification number1016694000
Number of Individuals Covered18
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $654
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $654
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered365
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $13,263
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,263
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered366
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $94,418
Total amount of fees paid to insurance companyUSD $4,683
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN GENERAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68373 )
Policy contract number8705
Policy instance 4
Insurance contract or identification number8705
Number of Individuals Covered340
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $9,405
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 3
Insurance contract or identification number1016694000
Number of Individuals Covered25
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $6,445
Total amount of fees paid to insurance companyUSD $319
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract number1016694000
Policy instance 1
Insurance contract or identification number1016694000
Number of Individuals Covered325
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $87,310
Total amount of fees paid to insurance companyUSD $10,208
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract number1016694000
Policy instance 3
Insurance contract or identification number1016694000
Number of Individuals Covered31
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $8,330
Total amount of fees paid to insurance companyUSD $974
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN GENERAL ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68373 )
Policy contract number8705
Policy instance 4
Insurance contract or identification number8705
Number of Individuals Covered210
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $6,576
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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