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AMERICAN COOLAIR CORPORATION 401k Plan overview

Plan NameAMERICAN COOLAIR CORPORATION
Plan identification number 508

AMERICAN COOLAIR CORPORATION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

AMERICAN COOLAIR CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN COOLAIR CORPORATION
Employer identification number (EIN):590141620
NAIC Classification:333410

Additional information about AMERICAN COOLAIR CORPORATION

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1928-05-04
Company Identification Number: 117163
Legal Registered Office Address: 6962 ALMOURS DR

JACKSONVILLE

32217

More information about AMERICAN COOLAIR CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN COOLAIR CORPORATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5082019-06-01HARRY M GRAVES2020-12-07
5082018-06-01HARRY M GRAVES2019-12-04
5082017-06-01
5082016-06-01
5082015-06-01
5082014-06-01
5082013-06-01
5082012-06-01HARRY M GRAVES
5082011-06-01HARRY M GRAVES
5082010-06-01HARRY M GRAVES
5082009-06-012010-12-14
5082009-06-01TIM HOWARD

Plan Statistics for AMERICAN COOLAIR CORPORATION

401k plan membership statisitcs for AMERICAN COOLAIR CORPORATION

Measure Date Value
2019: AMERICAN COOLAIR CORPORATION 2019 401k membership
Total participants, beginning-of-year2019-06-0197
Total number of active participants reported on line 7a of the Form 55002019-06-0173
Total of all active and inactive participants2019-06-0173
2018: AMERICAN COOLAIR CORPORATION 2018 401k membership
Total participants, beginning-of-year2018-06-01104
Total number of active participants reported on line 7a of the Form 55002018-06-0197
Total of all active and inactive participants2018-06-0197
2017: AMERICAN COOLAIR CORPORATION 2017 401k membership
Total participants, beginning-of-year2017-06-0199
Total number of active participants reported on line 7a of the Form 55002017-06-01104
Total of all active and inactive participants2017-06-01104
2016: AMERICAN COOLAIR CORPORATION 2016 401k membership
Total participants, beginning-of-year2016-06-0188
Total number of active participants reported on line 7a of the Form 55002016-06-0199
Total of all active and inactive participants2016-06-0199
2015: AMERICAN COOLAIR CORPORATION 2015 401k membership
Total participants, beginning-of-year2015-06-0182
Total number of active participants reported on line 7a of the Form 55002015-06-0188
Total of all active and inactive participants2015-06-0188
2014: AMERICAN COOLAIR CORPORATION 2014 401k membership
Total participants, beginning-of-year2014-06-0189
Total number of active participants reported on line 7a of the Form 55002014-06-0182
Total of all active and inactive participants2014-06-0182
2013: AMERICAN COOLAIR CORPORATION 2013 401k membership
Total participants, beginning-of-year2013-06-0181
Total number of active participants reported on line 7a of the Form 55002013-06-0189
Total of all active and inactive participants2013-06-0189
2012: AMERICAN COOLAIR CORPORATION 2012 401k membership
Total participants, beginning-of-year2012-06-0186
Total number of active participants reported on line 7a of the Form 55002012-06-0181
Total of all active and inactive participants2012-06-0181
2011: AMERICAN COOLAIR CORPORATION 2011 401k membership
Total participants, beginning-of-year2011-06-0182
Total number of active participants reported on line 7a of the Form 55002011-06-0186
Total of all active and inactive participants2011-06-0186
2010: AMERICAN COOLAIR CORPORATION 2010 401k membership
Total participants, beginning-of-year2010-06-0188
Total number of active participants reported on line 7a of the Form 55002010-06-0182
Total of all active and inactive participants2010-06-0182
2009: AMERICAN COOLAIR CORPORATION 2009 401k membership
Total participants, beginning-of-year2009-06-0190
Total number of active participants reported on line 7a of the Form 55002009-06-0188
Total of all active and inactive participants2009-06-0188
Total participants2009-06-0188

Financial Data on AMERICAN COOLAIR CORPORATION

Measure Date Value
2020 : AMERICAN COOLAIR CORPORATION 2020 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-05-31No
Was this plan covered by a fidelity bond2020-05-31No
If this is an individual account plan, was there a blackout period2020-05-31No
Were there any nonexempt tranactions with any party-in-interest2020-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-05-31No
Were any leases to which the plan was party in default or uncollectible2020-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-05-31No
Was there a failure to transmit to the plan any participant contributions2020-05-31No
Has the plan failed to provide any benefit when due under the plan2020-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-05-31No
Did the plan have assets held for investment2020-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-05-31No
2019 : AMERICAN COOLAIR CORPORATION 2019 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-05-31No
Was this plan covered by a fidelity bond2019-05-31No
If this is an individual account plan, was there a blackout period2019-05-31No
Were there any nonexempt tranactions with any party-in-interest2019-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-05-31No
Were any leases to which the plan was party in default or uncollectible2019-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-05-31No
Was there a failure to transmit to the plan any participant contributions2019-05-31No
Has the plan failed to provide any benefit when due under the plan2019-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-05-31No
Did the plan have assets held for investment2019-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-05-31No
2018 : AMERICAN COOLAIR CORPORATION 2018 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-05-31No
Was this plan covered by a fidelity bond2018-05-31No
If this is an individual account plan, was there a blackout period2018-05-31No
Were there any nonexempt tranactions with any party-in-interest2018-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-05-31No
Were any leases to which the plan was party in default or uncollectible2018-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-05-31No
Was there a failure to transmit to the plan any participant contributions2018-05-31No
Has the plan failed to provide any benefit when due under the plan2018-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-05-31No
Did the plan have assets held for investment2018-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-05-31No
2017 : AMERICAN COOLAIR CORPORATION 2017 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-05-31No
Was this plan covered by a fidelity bond2017-05-31No
If this is an individual account plan, was there a blackout period2017-05-31No
Were there any nonexempt tranactions with any party-in-interest2017-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-05-31No
Were any leases to which the plan was party in default or uncollectible2017-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-05-31No
Was there a failure to transmit to the plan any participant contributions2017-05-31No
Has the plan failed to provide any benefit when due under the plan2017-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-05-31No
Did the plan have assets held for investment2017-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-05-31No
2016 : AMERICAN COOLAIR CORPORATION 2016 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-05-31No
Was this plan covered by a fidelity bond2016-05-31No
If this is an individual account plan, was there a blackout period2016-05-31No
Were there any nonexempt tranactions with any party-in-interest2016-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-05-31No
Were any leases to which the plan was party in default or uncollectible2016-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-05-31No
Was there a failure to transmit to the plan any participant contributions2016-05-31No
Has the plan failed to provide any benefit when due under the plan2016-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-05-31No
Did the plan have assets held for investment2016-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-05-31No
2015 : AMERICAN COOLAIR CORPORATION 2015 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-05-31No
Was this plan covered by a fidelity bond2015-05-31No
If this is an individual account plan, was there a blackout period2015-05-31No
Were there any nonexempt tranactions with any party-in-interest2015-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-05-31No
Were any leases to which the plan was party in default or uncollectible2015-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-05-31No
Was there a failure to transmit to the plan any participant contributions2015-05-31No
Has the plan failed to provide any benefit when due under the plan2015-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-05-31No
Did the plan have assets held for investment2015-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-05-31No
2014 : AMERICAN COOLAIR CORPORATION 2014 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-05-31No
Was this plan covered by a fidelity bond2014-05-31No
If this is an individual account plan, was there a blackout period2014-05-31No
Were there any nonexempt tranactions with any party-in-interest2014-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-05-31No
Were any leases to which the plan was party in default or uncollectible2014-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-05-31No
Was there a failure to transmit to the plan any participant contributions2014-05-31No
Has the plan failed to provide any benefit when due under the plan2014-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-05-31No
Did the plan have assets held for investment2014-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-05-31No
2013 : AMERICAN COOLAIR CORPORATION 2013 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-05-31No
Was this plan covered by a fidelity bond2013-05-31No
If this is an individual account plan, was there a blackout period2013-05-31No
Were there any nonexempt tranactions with any party-in-interest2013-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-05-31No
Were any leases to which the plan was party in default or uncollectible2013-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-05-31No
Was there a failure to transmit to the plan any participant contributions2013-05-31No
Has the plan failed to provide any benefit when due under the plan2013-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-05-31No
Did the plan have assets held for investment2013-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-05-31No
2012 : AMERICAN COOLAIR CORPORATION 2012 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-05-31No
Was this plan covered by a fidelity bond2012-05-31No
If this is an individual account plan, was there a blackout period2012-05-31No
Were there any nonexempt tranactions with any party-in-interest2012-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-05-31No
Were any leases to which the plan was party in default or uncollectible2012-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-05-31No
Was there a failure to transmit to the plan any participant contributions2012-05-31No
Has the plan failed to provide any benefit when due under the plan2012-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-05-31No
Did the plan have assets held for investment2012-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-05-31No
2011 : AMERICAN COOLAIR CORPORATION 2011 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-05-31No
Was this plan covered by a fidelity bond2011-05-31No
If this is an individual account plan, was there a blackout period2011-05-31No
Were there any nonexempt tranactions with any party-in-interest2011-05-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-05-31No
Were any leases to which the plan was party in default or uncollectible2011-05-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-05-31No
Was there a failure to transmit to the plan any participant contributions2011-05-31No
Has the plan failed to provide any benefit when due under the plan2011-05-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-05-31No
Did the plan have assets held for investment2011-05-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-05-31No

Form 5500 Responses for AMERICAN COOLAIR CORPORATION

2019: AMERICAN COOLAIR CORPORATION 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: AMERICAN COOLAIR CORPORATION 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: AMERICAN COOLAIR CORPORATION 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: AMERICAN COOLAIR CORPORATION 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: AMERICAN COOLAIR CORPORATION 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes
2014: AMERICAN COOLAIR CORPORATION 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: AMERICAN COOLAIR CORPORATION 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: AMERICAN COOLAIR CORPORATION 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedYes
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: AMERICAN COOLAIR CORPORATION 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2010: AMERICAN COOLAIR CORPORATION 2010 form 5500 responses
2010-06-01Type of plan entitySingle employer plan
2010-06-01Plan funding arrangement – InsuranceYes
2010-06-01Plan benefit arrangement – InsuranceYes
2009: AMERICAN COOLAIR CORPORATION 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10063891001
Policy instance 3
Insurance contract or identification number10063891001
Number of Individuals Covered59
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $487
Total amount of fees paid to insurance companyUSD $0
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 $487
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number608905
Policy instance 5
Insurance contract or identification number608905
Number of Individuals Covered51
Insurance policy start date2019-06-01
Insurance policy end date2020-06-01
Total amount of commissions paid to insurance brokerUSD $2,101
Total amount of fees paid to insurance companyUSD $158
Dental 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 $2,101
Amount paid for insurance broker fees158
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 2
Insurance contract or identification number15109
Number of Individuals Covered5
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,048
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
Commission paid to Insurance BrokerUSD $4,048
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 1
Insurance contract or identification number15109
Number of Individuals Covered59
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $25,378
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
Commission paid to Insurance BrokerUSD $25,378
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number424418
Policy instance 6
Insurance contract or identification number424418
Number of Individuals Covered21
Insurance policy start date2019-06-01
Insurance policy end date2020-06-01
Total amount of commissions paid to insurance brokerUSD $1,651
Total amount of fees paid to insurance companyUSD $83
Life 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 $1,651
Amount paid for insurance broker fees83
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0741843
Policy instance 7
Insurance contract or identification numberR0741843
Number of Individuals Covered61
Insurance policy start date2019-06-01
Insurance policy end date2020-06-01
Total amount of commissions paid to insurance brokerUSD $1,660
Total amount of fees paid to insurance companyUSD $0
Temporary Disability 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 $1,660
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number422185
Policy instance 4
Insurance contract or identification number422185
Number of Individuals Covered73
Insurance policy start date2019-06-01
Insurance policy end date2020-06-01
Total amount of commissions paid to insurance brokerUSD $1,395
Total amount of fees paid to insurance companyUSD $70
Life 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 $1,395
Amount paid for insurance broker fees70
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 2
Insurance contract or identification number15109
Number of Individuals Covered6
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $7,708
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
Commission paid to Insurance BrokerUSD $7,708
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10063891001
Policy instance 3
Insurance contract or identification number10063891001
Number of Individuals Covered70
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $654
Total amount of fees paid to insurance companyUSD $0
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 $592
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number422185
Policy instance 4
Insurance contract or identification number422185
Number of Individuals Covered97
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $1,554
Total amount of fees paid to insurance companyUSD $78
Life 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 $1,554
Amount paid for insurance broker fees78
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number608905
Policy instance 5
Insurance contract or identification number608905
Number of Individuals Covered59
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $2,478
Total amount of fees paid to insurance companyUSD $496
Dental 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 $2,478
Amount paid for insurance broker fees496
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0741843
Policy instance 7
Insurance contract or identification numberR0741843
Number of Individuals Covered66
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $7,237
Total amount of fees paid to insurance companyUSD $0
Temporary Disability 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 $7,237
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 1
Insurance contract or identification number15109
Number of Individuals Covered63
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $75,174
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
Commission paid to Insurance BrokerUSD $75,174
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number424418
Policy instance 6
Insurance contract or identification number424418
Number of Individuals Covered39
Insurance policy start date2018-06-01
Insurance policy end date2019-06-01
Total amount of commissions paid to insurance brokerUSD $1,457
Total amount of fees paid to insurance companyUSD $73
Life 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 $1,457
Amount paid for insurance broker fees73
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFO13641
Policy instance 3
Insurance contract or identification numberFO13641
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life 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 nameHARDEN & ASSOCIATES
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 2
Insurance contract or identification number15109
Number of Individuals Covered36
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $16,276
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
Commission paid to Insurance BrokerUSD $16,276
Insurance broker organization code?3
Insurance broker nameHARDEN AND ASSOCIATES
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number62831
Policy instance 4
Insurance contract or identification number62831
Number of Individuals Covered56
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $2,749
Total amount of fees paid to insurance companyUSD $0
Life 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 $2,549
Insurance broker organization code?3
Insurance broker nameCREATIVE WORKSITE SOLUTIONS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number62831
Policy instance 5
Insurance contract or identification number62831
Number of Individuals Covered56
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $489
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $268
Insurance broker organization code?3
Insurance broker nameHYLANT GROUP INC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number62831
Policy instance 6
Insurance contract or identification number62831
Number of Individuals Covered56
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $5,327
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
Commission paid to Insurance BrokerUSD $5,320
Insurance broker organization code?3
Insurance broker name
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10063891001
Policy instance 7
Insurance contract or identification number10063891001
Number of Individuals Covered86
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $685
Total amount of fees paid to insurance companyUSD $0
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 $685
Insurance broker organization code?3
Insurance broker nameHARDEN & ASSOCIATES INC
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number000000422185
Policy instance 8
Insurance contract or identification number000000422185
Number of Individuals Covered35
Insurance policy start date2017-06-01
Insurance policy end date2018-06-01
Total amount of commissions paid to insurance brokerUSD $2,967
Total amount of fees paid to insurance companyUSD $0
Dental 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 $2,967
Insurance broker organization code?3
Insurance broker nameHARDEN & ASSOCIATES INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number422185
Policy instance 9
Insurance contract or identification number422185
Number of Individuals Covered104
Insurance policy start date2017-06-01
Insurance policy end date2018-06-01
Total amount of commissions paid to insurance brokerUSD $1,702
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,702
Insurance broker organization code?3
Insurance broker nameHARDEN & ASSOCIATES INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number15109
Policy instance 1
Insurance contract or identification number15109
Number of Individuals Covered47
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $20,930
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
Commission paid to Insurance BrokerUSD $20,930
Insurance broker organization code?3
Insurance broker nameHARDEN & ASSOCIATES

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