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YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NameYMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN
Plan identification number 501

YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT 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
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

YMCA OF SOUTH FLORIDA, INC. has sponsored the creation of one or more 401k plans.

Company Name:YMCA OF SOUTH FLORIDA, INC.
Employer identification number (EIN):590624464
NAIC Classification:713900

Additional information about YMCA OF SOUTH FLORIDA, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1964-02-20
Company Identification Number: 706855
Legal Registered Office Address: 900 SE 3RD AVENUE

FORT LAUDERDALE

33316

More information about YMCA OF SOUTH FLORIDA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01
5012017-04-01JOHN PULEIO JOHN PULEIO2018-07-30
5012016-04-01JOHN PULEIO JOHN PULEIO2017-10-27
5012016-01-01JOHN PULEIO JOHN PULEIO2016-12-21
5012015-01-01JOHN PULEIO JOHN PULEIO2016-10-17
5012011-01-01NADINE LEWIS
5012009-01-01NADINE LEWIS

Plan Statistics for YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN

Measure Date Value
2022: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01162
Total number of active participants reported on line 7a of the Form 55002022-04-01186
Number of retired or separated participants receiving benefits2022-04-012
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01188
2021: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01166
Total number of active participants reported on line 7a of the Form 55002021-04-01164
Number of retired or separated participants receiving benefits2021-04-013
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01167
2020: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01234
Total number of active participants reported on line 7a of the Form 55002020-04-01161
Number of retired or separated participants receiving benefits2020-04-0114
Total of all active and inactive participants2020-04-01175
2019: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01215
Total number of active participants reported on line 7a of the Form 55002019-04-01231
Number of retired or separated participants receiving benefits2019-04-013
Total of all active and inactive participants2019-04-01234
2018: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01219
Total number of active participants reported on line 7a of the Form 55002018-04-01213
Number of retired or separated participants receiving benefits2018-04-012
Total of all active and inactive participants2018-04-01215
2017: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01238
Total number of active participants reported on line 7a of the Form 55002017-04-01205
Number of retired or separated participants receiving benefits2017-04-0114
Total of all active and inactive participants2017-04-01219
2016: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01186
Total number of active participants reported on line 7a of the Form 55002016-04-01236
Number of retired or separated participants receiving benefits2016-04-012
Total of all active and inactive participants2016-04-01238
Total participants, beginning-of-year2016-01-01185
Total number of active participants reported on line 7a of the Form 55002016-01-01184
Number of retired or separated participants receiving benefits2016-01-012
Total of all active and inactive participants2016-01-01186
2015: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01167
Total number of active participants reported on line 7a of the Form 55002015-01-01182
Number of retired or separated participants receiving benefits2015-01-013
Total of all active and inactive participants2015-01-01185
2011: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01146
Total number of active participants reported on line 7a of the Form 55002011-01-0196
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0196
2009: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01100
Total number of active participants reported on line 7a of the Form 55002009-01-01167
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01167

Form 5500 Responses for YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN

2022: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-01-01Type of plan entitySingle employer plan
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2011: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: YMCA OF SOUTH FLORIDA, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number924111
Policy instance 3
Insurance contract or identification number924111
Number of Individuals Covered272
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $4,229
Total amount of fees paid to insurance companyUSD $52,309
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,072,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,229
Amount paid for insurance broker fees44933
Additional information about fees paid to insurance brokerSERVICE FEE AGGREEMENT
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered185
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $18,294
Total amount of fees paid to insurance companyUSD $1,068
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $119,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,294
Amount paid for insurance broker fees1068
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberAAA52
Policy instance 1
Insurance contract or identification numberAAA52
Number of Individuals Covered41
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $3,753
Total amount of fees paid to insurance companyUSD $124
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER CARE, CRITICAL CARE, HOSPITAL PROTECTION, ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,565
Amount paid for insurance broker fees84
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberAAA52
Policy instance 1
Insurance contract or identification numberAAA52
Number of Individuals Covered36
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $3,975
Total amount of fees paid to insurance companyUSD $224
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER CARE, CRITICAL CARE, HOSPITAL PROTECTION, ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,475
Amount paid for insurance broker fees153
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered164
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $15,815
Total amount of fees paid to insurance companyUSD $3,512
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $103,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,815
Amount paid for insurance broker fees3512
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number924111
Policy instance 3
Insurance contract or identification number924111
Number of Individuals Covered245
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $2,931
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $941,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,931
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0625729
Policy instance 4
Insurance contract or identification number0625729
Number of Individuals Covered149
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $50,848
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,271,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees50848
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625729
Policy instance 3
Insurance contract or identification number00625729
Number of Individuals Covered140
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $4,501
Total amount of fees paid to insurance companyUSD $1,380
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,501
Amount paid for insurance broker fees1380
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered155
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $19,100
Total amount of fees paid to insurance companyUSD $5,709
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $124,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,100
Amount paid for insurance broker fees5709
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number82-2723296
Policy instance 1
Insurance contract or identification number82-2723296
Number of Individuals Covered44
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $6,468
Total amount of fees paid to insurance companyUSD $301
Health Insurance Welfare BenefitYes
Other welfare benefits providedCANCER,CRITICAL CARE, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $51,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,788
Amount paid for insurance broker fees213
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered234
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $18,063
Total amount of fees paid to insurance companyUSD $5,950
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $118,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,709
Amount paid for insurance broker fees5950
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number82-2723296
Policy instance 1
Insurance contract or identification number82-2723296
Number of Individuals Covered57
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $7,992
Total amount of fees paid to insurance companyUSD $379
Health Insurance Welfare BenefitYes
Other welfare benefits providedCANCER,CRITICAL CARE, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $57,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,058
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0625729
Policy instance 4
Insurance contract or identification number0625729
Number of Individuals Covered187
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $5,662
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,662
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625729
Policy instance 3
Insurance contract or identification number00625729
Number of Individuals Covered235
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $56,464
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,411,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees56464
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914255
Policy instance 3
Insurance contract or identification number914255
Number of Individuals Covered319
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $5,467
Total amount of fees paid to insurance companyUSD $56,243
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,444,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,467
Amount paid for insurance broker fees56243
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered206
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $19,695
Total amount of fees paid to insurance companyUSD $5,735
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $128,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,309
Amount paid for insurance broker fees5735
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number82-2723296
Policy instance 1
Insurance contract or identification number82-2723296
Number of Individuals Covered60
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $7,592
Total amount of fees paid to insurance companyUSD $182
Health Insurance Welfare BenefitYes
Other welfare benefits providedCANCER,CRITICAL CARE, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $51,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,456
Amount paid for insurance broker fees74
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
AVMED HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 95263 )
Policy contract number125291
Policy instance 3
Insurance contract or identification number125291
Number of Individuals Covered253
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $59,749
Total amount of fees paid to insurance companyUSD $4,764
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,563,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,749
Amount paid for insurance broker fees4764
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00486304
Policy instance 2
Insurance contract or identification number00486304
Number of Individuals Covered214
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $23,315
Total amount of fees paid to insurance companyUSD $8,130
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $212,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,858
Amount paid for insurance broker fees8130
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FLORIDA
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number58-0663085
Policy instance 1
Insurance contract or identification number58-0663085
Number of Individuals Covered60
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $7,025
Total amount of fees paid to insurance companyUSD $721
Health Insurance Welfare BenefitYes
Other welfare benefits providedCANCER,CRITICAL CARE, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $56,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,725
Amount paid for insurance broker fees211
Additional information about fees paid to insurance brokerBROKER FEE
Insurance broker organization code?3
Insurance broker nameJENNIE HAWKINS

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