EMPLOYEE HEALTH PLAN 401k Plan overview

Plan Name	EMPLOYEE HEALTH PLAN
Plan identification number	503

EMPLOYEE HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Prepaid legal Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

JUPITER MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:	JUPITER MEDICAL CENTER
Employer identification number (EIN):	591460239
NAIC Classification:	622000
NAIC Description:	Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2021-10-01	JERRILYNN MARAZZO	2023-04-10
503	2020-10-01	JULIA CLICK	2022-05-26
503	2019-10-01	JULIA CLICK	2021-04-16
503	2018-10-01	JESSICA MONTOYA	2020-03-13
503	2017-10-01
503	2016-10-01
503	2015-10-01	ELIZABETH DENSMORE
503	2014-10-01	ELIZABETH DENSMORE
503	2013-10-01	ELIZABETH DENSMORE
503	2012-10-01	ALICE DEMARCO
503	2011-10-01	GAIL ODEA
503	2009-01-01	JOHN WOLF		JOHN WOLF	2010-05-26

Plan Statistics for EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN

Measure	Date	Value
2021: EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	1,382
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	1,541
Number of retired or separated participants receiving benefits	2021-10-01	9
Number of other retired or separated participants entitled to future benefits	2021-10-01	0
Total of all active and inactive participants	2021-10-01	1,550
2020: EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	1,417
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	1,400
Number of retired or separated participants receiving benefits	2020-10-01	11
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	1,411
2019: EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	1,387
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	1,417
Number of retired or separated participants receiving benefits	2019-10-01	16
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	1,433
2018: EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	1,242
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	1,303
Number of retired or separated participants receiving benefits	2018-10-01	16
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	1,319
2017: EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	928
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	951
Number of retired or separated participants receiving benefits	2017-10-01	14
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	965
2016: EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	914
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	941
Number of retired or separated participants receiving benefits	2016-10-01	6
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	947
2015: EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	1,126
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	1,174
Number of retired or separated participants receiving benefits	2015-10-01	6
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	1,180
2014: EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	1,110
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	1,106
Number of retired or separated participants receiving benefits	2014-10-01	10
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	1,116
2013: EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	1,024
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	882
Number of retired or separated participants receiving benefits	2013-10-01	7
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	889
2012: EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	921
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	921
Number of retired or separated participants receiving benefits	2012-10-01	9
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	930
2011: EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	2,080
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	2,040
Total of all active and inactive participants	2011-10-01	2,040
Total participants	2011-10-01	2,040
2009: EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,132
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,130
Total of all active and inactive participants	2009-01-01	1,130

Form 5500 Responses for EMPLOYEE HEALTH PLAN

2021: EMPLOYEE HEALTH PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Submission has been amended	No
2021-10-01	This submission is the final filing	No
2021-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-10-01	Plan is a collectively bargained plan	No
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: EMPLOYEE HEALTH PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: EMPLOYEE HEALTH PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: EMPLOYEE HEALTH PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	First time form 5500 has been submitted	Yes
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	5
Insurance contract or identification number 231929 Number of Individuals Covered 1374 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $25,846 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $584,991 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $25,846 Insurance broker organization code? 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	10340881001
Policy instance	10
Insurance contract or identification number 10340881001 Number of Individuals Covered 13 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $363 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	92018
Policy instance	1
Insurance contract or identification number 92018 Number of Individuals Covered 268 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $10,480 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $83,847 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,336 Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 57 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $6,407 Total amount of fees paid to insurance company USD $92 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $30,261 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,311 Insurance broker organization code? 3 Amount paid for insurance broker fees 92 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	3
Insurance contract or identification number 99166281001 Number of Individuals Covered 1250 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $96,303 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LEGALPLANS, USA (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	00000
Policy instance	4
Insurance contract or identification number 00000 Number of Individuals Covered 100 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $2,108 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $21,075 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,108 Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	6
Insurance contract or identification number V4746 Number of Individuals Covered 290 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $12,456 Total amount of fees paid to insurance company USD $220 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS 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 Carrier USD $81,719 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,334 Insurance broker organization code? 3 Amount paid for insurance broker fees 220 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	7
Insurance contract or identification number V4746 Number of Individuals Covered 319 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $11,403 Total amount of fees paid to insurance company USD $184 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided 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 Carrier USD $78,834 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,064 Insurance broker organization code? 3 Amount paid for insurance broker fees 184 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0223501
Policy instance	8
Insurance contract or identification number 0223501 Number of Individuals Covered 1371 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $565,116 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION (National Association of Insurance Commissioners NAIC id number: 52009 )
Policy contract number	0224486
Policy instance	9
Insurance contract or identification number 0224486 Number of Individuals Covered 196 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $33,838 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION (National Association of Insurance Commissioners NAIC id number: 52009 )
Policy contract number	0224486
Policy instance	9
Insurance contract or identification number 0224486 Number of Individuals Covered 196 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $31,853 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0223501
Policy instance	8
Insurance contract or identification number 0223501 Number of Individuals Covered 1307 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $16,600 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $548,125 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 16600 Additional information about fees paid to insurance broker ENROLLMENT FEES Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	1
Insurance contract or identification number 0000092018 Number of Individuals Covered 245 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $9,870 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $75,401 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,885 Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 63 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $15,902 Total amount of fees paid to insurance company USD $221 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $35,731 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,199 Insurance broker organization code? 3 Amount paid for insurance broker fees 221 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	3
Insurance contract or identification number 99166281001 Number of Individuals Covered 806 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $105,971 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LEGALPLANS, USA (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	00000
Policy instance	4
Insurance contract or identification number 00000 Number of Individuals Covered 28 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,017 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $20,166 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,017 Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	5
Insurance contract or identification number 231929 Number of Individuals Covered 1371 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $27,346 Total amount of fees paid to insurance company USD $8,509 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $632,465 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $27,346 Amount paid for insurance broker fees 8509 Additional information about fees paid to insurance broker BONUS Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	6
Insurance contract or identification number V4746 Number of Individuals Covered 265 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $10,750 Total amount of fees paid to insurance company USD $646 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS 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 Carrier USD $83,719 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,415 Amount paid for insurance broker fees 646 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	7
Insurance contract or identification number V4746 Number of Individuals Covered 355 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $13,718 Total amount of fees paid to insurance company USD $475 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided 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 Carrier USD $84,626 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,305 Insurance broker organization code? 3 Amount paid for insurance broker fees 475 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	1
Insurance contract or identification number 0000092018 Number of Individuals Covered 192 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $4,722 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $38,165 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,161 Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 43 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $1,424 Total amount of fees paid to insurance company USD $48 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $17,102 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,187 Amount paid for insurance broker fees 48 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	3
Insurance contract or identification number 76732 Number of Individuals Covered 264 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $40,499 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	4
Insurance contract or identification number 16071 Number of Individuals Covered 675 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $514,553 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	5
Insurance contract or identification number 99166281001 Number of Individuals Covered 1292 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $84,345 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	7
Insurance contract or identification number 231929 Number of Individuals Covered 1332 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $21,673 Total amount of fees paid to insurance company USD $2,472 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $535,555 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $21,673 Amount paid for insurance broker fees 2472 Additional information about fees paid to insurance broker BONUS Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	8
Insurance contract or identification number V4746 Number of Individuals Covered 247 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $3,912 Total amount of fees paid to insurance company USD $805 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS 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 Carrier USD $46,627 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,678 Amount paid for insurance broker fees 805 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	9
Insurance contract or identification number V4746 Number of Individuals Covered 292 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $4,303 Total amount of fees paid to insurance company USD $401 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided 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 Carrier USD $48,089 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,866 Amount paid for insurance broker fees 401 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
LEGALPLANS, USA (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	00000
Policy instance	6
Insurance contract or identification number 00000 Number of Individuals Covered 90 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $1,922 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $19,222 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1922 Additional information about fees paid to insurance broker SERVICE FEE Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	1
Insurance contract or identification number 0000092018 Number of Individuals Covered 141 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $6,172 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $40,833 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,086 Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 41 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $466 Total amount of fees paid to insurance company USD $10 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $19,938 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $331 Insurance broker organization code? 3 Amount paid for insurance broker fees 10 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	3
Insurance contract or identification number V4746 Number of Individuals Covered 16 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $990 Total amount of fees paid to insurance company USD $110 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $17,879 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $722 Insurance broker organization code? 3 Amount paid for insurance broker fees 110 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	4
Insurance contract or identification number 76732 Number of Individuals Covered 165 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $27,955 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	5
Insurance contract or identification number 16071 Number of Individuals Covered 679 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $524,293 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	6
Insurance contract or identification number 99166281001 Number of Individuals Covered 1194 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $68,017 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LEGALPLANS, USA (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract number	00000
Policy instance	7
Insurance contract or identification number 00000 Number of Individuals Covered 70 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $1,376 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $13,765 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1376 Additional information about fees paid to insurance broker SERVICE FEE Insurance broker organization code? 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	8
Insurance contract or identification number 231929 Number of Individuals Covered 1237 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $20,482 Total amount of fees paid to insurance company USD $4,320 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $530,511 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $20,482 Amount paid for insurance broker fees 4320 Additional information about fees paid to insurance broker BONUS Insurance broker organization code? 3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	9
Insurance contract or identification number V4746 Number of Individuals Covered 80 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,063 Total amount of fees paid to insurance company USD $50 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS 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 Carrier USD $34,764 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $753 Insurance broker organization code? 3 Amount paid for insurance broker fees 50 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	10
Insurance contract or identification number V4746 Number of Individuals Covered 234 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $3,550 Total amount of fees paid to insurance company USD $345 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided 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 Carrier USD $53,414 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,892 Amount paid for insurance broker fees 345 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	6
Insurance contract or identification number 99166281001 Number of Individuals Covered 1139 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $82,167 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	7
Insurance contract or identification number 1500802 Number of Individuals Covered 66 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $14,586 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	8
Insurance contract or identification number 231929 Number of Individuals Covered 1200 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $2,316 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $376,466 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	9
Insurance contract or identification number V4746 Number of Individuals Covered 78 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,486 Total amount of fees paid to insurance company USD $62 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS 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 Carrier USD $39,240 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	10
Insurance contract or identification number V4746 Number of Individuals Covered 233 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $4,593 Total amount of fees paid to insurance company USD $461 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided 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 Carrier USD $53,423 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	5
Insurance contract or identification number 16071 Number of Individuals Covered 640 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $557,423 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	4
Insurance contract or identification number 76732 Number of Individuals Covered 154 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $27,853 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	3
Insurance contract or identification number V4746 Number of Individuals Covered 141 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $8,101 Total amount of fees paid to insurance company USD $391 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $103,615 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 28 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $772 Total amount of fees paid to insurance company USD $19 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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $21,156 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	1
Insurance contract or identification number 0000092018 Number of Individuals Covered 140 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $3,900 Total amount of fees paid to insurance company USD $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 plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $26,393 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	7
Insurance contract or identification number 1500802 Number of Individuals Covered 61 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $37 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LEGAL 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 Carrier USD $12,675 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 37 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3 Insurance broker name MERCER HUMAN RESOURCE CONSULTING
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	99166281001
Policy instance	6
Insurance contract or identification number 99166281001 Number of Individuals Covered 1031 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $64,869 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	5
Insurance contract or identification number 16071 Number of Individuals Covered 1119 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $458,175 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	4
Insurance contract or identification number 76732 Number of Individuals Covered 225 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $21,664 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	3
Insurance contract or identification number V4746 Number of Individuals Covered 282 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $23,187 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $266,675 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $17,135 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	2
Insurance contract or identification number V4746 Number of Individuals Covered 282 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $4,971 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $36,013 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,039 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	1
Insurance contract or identification number 0000092018 Number of Individuals Covered 86 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $62 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $417 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $31 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	8
Insurance contract or identification number 231929 Number of Individuals Covered 1121 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $203,821 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	0000092018
Policy instance	4
Insurance contract or identification number 0000092018 Number of Individuals Covered 102 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $3,150 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $21,005 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,575 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	1
Insurance contract or identification number 1500802 Number of Individuals Covered 59 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $18 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided PREPAID LEGAL 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 Carrier USD $16,312 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 18 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	5
Insurance contract or identification number V4746 Number of Individuals Covered 349 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $15,978 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $32,994 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $15,978 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	V4746
Policy instance	6
Insurance contract or identification number V4746 Number of Individuals Covered 349 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $64,810 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $239,751 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $64,810 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	940570200 DVIO
Policy instance	9
Insurance contract or identification number 940570200 DVIO Number of Individuals Covered 51 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $605 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $6,046 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $605 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	940570100 DVIO
Policy instance	7
Insurance contract or identification number 940570100 DVIO Number of Individuals Covered 567 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $5,711 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $57,106 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,711 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	3
Insurance contract or identification number 76732 Number of Individuals Covered 213 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $29,837 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	231929
Policy instance	8
Insurance contract or identification number 231929 Number of Individuals Covered 1063 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $185,100 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	2
Insurance contract or identification number 16071 Number of Individuals Covered 1200 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $460,281 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9803859
Policy instance	1
Insurance contract or identification number 9803859 Number of Individuals Covered 1187 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $10,302 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $95,454 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,500 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH AND BENEFITS, LLC
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	2
Insurance contract or identification number 1500802 Number of Individuals Covered 83 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,841 Total amount of fees paid to insurance company USD $43 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided PRE-PAID LEGAL 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 Carrier USD $19,496 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,841 Amount paid for insurance broker fees 23 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3 Insurance broker name MERCER HUMAN RESOURCE CONSULTING
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	123330
Policy instance	3
Insurance contract or identification number 123330 Number of Individuals Covered 0 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,976 Total amount of fees paid to insurance company USD $296 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,976 Amount paid for insurance broker fees 296 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	LK 962985
Policy instance	4
Insurance contract or identification number LK 962985 Number of Individuals Covered 882 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $5,114 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No 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 Carrier USD $34,094 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,114 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	FLX964236
Policy instance	6
Insurance contract or identification number FLX964236 Number of Individuals Covered 882 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $20,725 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $139,533 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $20,725 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	16071
Policy instance	7
Insurance contract or identification number 16071 Number of Individuals Covered 1247 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $27,454 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $548,856 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $27,454 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	76732
Policy instance	8
Insurance contract or identification number 76732 Number of Individuals Covered 235 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,022 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $14,993 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,022 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK 965846
Policy instance	5
Insurance contract or identification number OK 965846 Number of Individuals Covered 882 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,136 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $7,570 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,136 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	2
Insurance contract or identification number 1500802 Number of Individuals Covered 86 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $472 Total amount of fees paid to insurance company USD $23 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided PRE-PAID LEGAL 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 Carrier USD $4,662 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $472 Amount paid for insurance broker fees 23 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	123330
Policy instance	3
Insurance contract or identification number 123330 Number of Individuals Covered 1629 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $6,041 Total amount of fees paid to insurance company USD $906 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $144,856 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,041 Amount paid for insurance broker fees 906 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	FLX964236
Policy instance	4
Insurance contract or identification number FLX964236 Number of Individuals Covered 1016 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $7,092 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $47,278 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,092 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	LK 962985
Policy instance	5
Insurance contract or identification number LK 962985 Number of Individuals Covered 38 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $2,020 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No 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 Carrier USD $13,469 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,020 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	OK 965846
Policy instance	6
Insurance contract or identification number OK 965846 Number of Individuals Covered 1092 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $403 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT 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 Carrier USD $2,688 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $403 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL INC
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9803859
Policy instance	1
Insurance contract or identification number 9803859 Number of Individuals Covered 1157 Insurance policy start date 2012-10-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $2,248 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 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 Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No 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 Carrier USD $22,592 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,248 Insurance broker organization code? 3 Insurance broker name CORPORATE FINANCIAL
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3194708
Policy instance	1
Insurance contract or identification number 3194708 Number of Individuals Covered 2040 Insurance policy start date 2011-10-01 Insurance policy end date 2012-09-30 Total amount of fees paid to insurance company USD $79,350 Welfare Benefit Premiums Paid to Carrier USD $761,748 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9803859
Policy instance	4
Insurance contract or identification number 9803859 Number of Individuals Covered 1141 Insurance policy start date 2011-10-01 Insurance policy end date 2012-09-30 Total amount of commissions paid to insurance broker USD $10,251 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $95,133 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 )
Policy contract number	KJS
Policy instance	6
Insurance contract or identification number KJS Other welfare benefits provided PHARMACY BENEFIT MANAGER Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	5
Insurance contract or identification number 1500802 Number of Individuals Covered 88 Insurance policy start date 2011-10-01 Insurance policy end date 2012-09-30 Total amount of commissions paid to insurance broker USD $1,922 Total amount of fees paid to insurance company USD $94 Other welfare benefits provided LEGAL Welfare Benefit Premiums Paid to Carrier USD $18,927 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract number	FLX964236
Policy instance	2
Insurance contract or identification number FLX964236 Insurance policy start date 2011-10-01 Insurance policy end date 2012-09-30 Total amount of commissions paid to insurance broker USD $18,786 Total amount of fees paid to insurance company USD $5,283 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $125,240 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	123330
Policy instance	3
Insurance contract or identification number 123330 Number of Individuals Covered 1651 Insurance policy start date 2011-10-01 Insurance policy end date 2012-09-30 Total amount of commissions paid to insurance broker USD $39,730 Total amount of fees paid to insurance company USD $2,338 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $639,545 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	1500802
Policy instance	4
Insurance contract or identification number 1500802 Number of Individuals Covered 91 Insurance policy start date 2010-10-01 Insurance policy end date 2011-09-30 Total amount of commissions paid to insurance broker USD $1,827 Total amount of fees paid to insurance company USD $234 Other welfare benefits provided LEGAL Welfare Benefit Premiums Paid to Carrier USD $16,173 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9803859
Policy instance	3
Insurance contract or identification number 9803859 Number of Individuals Covered 1123 Insurance policy start date 2010-10-01 Insurance policy end date 2011-09-30 Total amount of commissions paid to insurance broker USD $5,640 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $71,228 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0123330
Policy instance	2
Insurance contract or identification number 0123330 Number of Individuals Covered 1659 Insurance policy start date 2010-10-01 Insurance policy end date 2011-09-30 Total amount of commissions paid to insurance broker USD $40,636 Total amount of fees paid to insurance company USD $7,799 Dental Insurance Welfare Benefit Yes Life Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit Yes Other welfare benefits provided AD&D Welfare Benefit Premiums Paid to Carrier USD $680,167 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3194708
Policy instance	1
Insurance contract or identification number 3194708 Number of Individuals Covered 2080 Insurance policy start date 2010-10-01 Insurance policy end date 2011-09-30 Health Insurance Welfare Benefit No Welfare Benefit Premiums Paid to Carrier USD $698,882 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

Potentially related plans

• EMPLOYEE HEALTH CARE PLAN [EIN = 270451448]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 263287805]
• EMPLOYEE HEALTH PLAN OF WHIT-FAM, INC. [EIN = 570833438]
• EMPLOYEE HEALTH PLAN OF EPSI, INC. [EIN = 752269095]
• EMPLOYEE HEALTH PLAN [EIN = 462859936]
• EMPLOYEE HEALTH AND WELFARE BENEFITS [EIN = 341455539]
• EMPLOYEE HEALTH PLAN OF VARIETY CANTEEN [EIN = 581163796]
• EMPLOYEE HEALTH & WELFARE BENEFIT PLAN [EIN = 560750913]
• EMPLOYEE HEALTH PLAN OF BILIKIN, INC. [EIN = 841256705]
• EMPLOYEE HEALTH PLAN OF CERWIN HOLDINGS, INC. [EIN = 261724817]
• EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION [EIN = 113070792]
• EMPLOYEE HEALTH PLAN-DENTAL [EIN = 462859936]
• EMPLOYEE HEALTH PLAN OF SUNBURST RESTAURANT, INC. [EIN = 593612563]
• EMPLOYEE HEALTH CARE PLAN OF TIMES PUBLISHING COMPANY, INC. [EIN = 250839114]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 760770964]
• EMPLOYEE HEALTH PLAN OF SAGO HOSPITALITY LLC [EIN = 900395162]
• EMPLOYEE HEALTH PLAN OF NORCAL FAST FOODS, INC [EIN = 800958155]
• EMPLOYEE HEALTH INSURANCE [EIN = 420730347]
• EMPLOYEE HEALTH PLAN OF JJ ENTERPRISES [EIN = 371247220]
• EMPLOYEE HEALTH PLAN-LONG TERM DISABILITY [EIN = 462859936]
• EMPLOYEE HEALTH PLAN-VISION [EIN = 462859936]
• EMPLOYEE HEALTH INSURANCE [EIN = 465441783]
• EMPLOYEE HEALTH AND DENTAL [EIN = 820189910]
• EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC [EIN = 391362748]
• EMPLOYEE HEALTH PLAN OF CHIODO CORP [EIN = 363767541]
• EMPLOYEE HEALTH PLAN OF GEORGETOWNE GROUP [EIN = 223014457]
• EMPLOYEE HEALTH PLAN OF CAMMILLERI HOLDINGS [EIN = 161533430]
• EMPLOYEE HEALTH PLAN OF SCREAMIN HOT CONCEPTS, LLC [EIN = 770700409]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 011273345]
• EMPLOYEE HEALTH PLAN OF AMPM ENTERPRISES INC. [EIN = 411821720]
• EMPLOYEE HEALTH PLAN OF RKJ AND SONS, LLC [EIN = 261145933]
• EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 [EIN = 204023518]
• EMPLOYEE HEALTH PLAN OF CROWN MANAGEMENT GROUP, INC [EIN = 593262694]
• EMPLOYEE HEALTH PLAN OF ALABAMA QUALITY, L.L.C. [EIN = 631176149]
• EMPLOYEE HEALTH AND DENTAL INSURANCE [EIN = 510064318]
• EMPLOYEE HEALTH AND WELFARE BENEFITS [EIN = 341455539]
• EMPLOYEE HEALTH PLAN OF CREATIVE FOODS CORP [EIN = 221893515]
• EMPLOYEE HEALTH PLAN OF KRISTI CO [EIN = 630972267]
• EMPLOYEE HEALTH PLAN OF C&C COMMERCIAL PROPERTIES, LLC [EIN = 870469975]
• EMPLOYEE HEALTH PLAN OF ASFOUR FAMILY CORP [EIN = 330407654]
• EMPLOYEE HEALTH PLAN OF FRANKLIN MANAGEMENT OF CLEVELAND, LLC [EIN = 371450807]
• EMPLOYEE HEALTH PLAN OF LANCASTER SUBWAY, INC [EIN = 561731360]
• EMPLOYEE HEALTH & WELFARE BENEFIT PLAN [EIN = 310846401]
• EMPLOYEE HEALTH CARE INSURANCE [EIN = 590657322]
• EMPLOYEE HEALTH PLAN OF JRDH RESTAURANTS, LLC [EIN = 262173917]
• EMPLOYEE HEALTH PLAN OF GREAT FOOD SERVICES [EIN = 010727775]
• EMPLOYEE HEALTH PLAN OF MIDNIGHT SUN SUBWAY LLC [EIN = 203166758]
• EMPLOYEE HEALTH PLAN OF ANRO MANAGEMENT [EIN = 760678939]
• EMPLOYEE HEALTH PLAN OF RC RESTAURANT GROUP LP [EIN = 710961282]
• EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT,LLC [EIN = 721488069]
• EMPLOYEE HEALTH PLAN OF LEE DEE VENDING CO [EIN = 720896137]
• EMPLOYEE HEALTH PLAN OF NAMG, LLC [EIN = 861094429]
• EMPLOYEE HEALTH PLAN OF JENCO FOODS/VOLUNTEER FOODS OF AL [EIN = 201926962]
• EMPLOYEE HEALTH PLAN OF DUOMARK [EIN = 562671434]
• EMPLOYEE HEALTH PLAN OF JS FOODS [EIN = 953781342]
• EMPLOYEE HEALTH PLAN-LIFE AND AD&D [EIN = 462859936]
• EMPLOYEE HEALTH PLAN OF TEXAS SKI RANCH LP [EIN = 742970301]
• EMPLOYEE HEALTH PLAN OF FIRST ALBERN FOODS, LTD. [EIN = 561526997]
• EMPLOYEE HEALTH PLAN FOR READY MIX USA [EIN = 203037056]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PROGRAM OF CTS CORPORATION [EIN = 310930471]
• EMPLOYEE HEALTH PLAN OF RT BWW, LLC [EIN = 300447835]
• EMPLOYEE HEALTH PLAN OF SHORCO [EIN = 760246812]
• EMPLOYEE HEALTH PLAN OF NELDA, LLC [EIN = 743237725]
• EMPLOYEE HEALTH PLAN OF TALARICO [EIN = 770369481]
• EMPLOYEE HEALTH PLAN OF JMP PIZZA INC DBA DOMINOS PIZZA [EIN = 651123143]
• EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC [EIN = 251405563]
• EMPLOYEE HEALTH PLAN OF KOSTEL [EIN = 751679949]
• EMPLOYEE HEALTH PLAN OF ARE, INC. [EIN = 521983944]
• EMPLOYEE HEALTH PLAN OF HAKIMIANPOUR SANTA MONICA GROUP,LLC [EIN = 954862674]
• EMPLOYEE HEALTH PLAN OF SERTEX OF LONGVIEW INC. [EIN = 751860964]
• EMPLOYEE HEALTH PLAN OF ROJAN, INC. [EIN = 760437011]
• EMPLOYEE HEALTH PLAN OF REPUBLIC FOODS, INC [EIN = 521261792]
• EMPLOYEE HEALTH PLAN OF CLASSIC FOODS, INC. [EIN = 223337082]
• EMPLOYEE HEALTH PLAN OF ZELLMER, LLC [EIN = 010583952]
• EMPLOYEE HEALTH PLAN OF BWW SOUTHERN MGT [EIN = 272342180]
• EMPLOYEE HEALTH PLAN OF CALRES, INC [EIN = 731076008]
• EMPLOYEE HEALTH PLAN OF MEINEKE CAR CARE [EIN = 208606231]
• EMPLOYEE HEALTH PLAN OF PASTA QUIK, LP [EIN = 752405010]
• EMPLOYEE HEALTH PLAN OF MASTORAN CORPORATION [EIN = 042965675]
• EMPLOYEE HEALTH PLAN OF SEASEVEN,LLC [EIN = 461610396]
• EMPLOYEE HEALTH PLAN OF FOCUSED MANAGEMENT EXPERTS,INC. [EIN = 311435137]
• EMPLOYEE HEALTH AND WELFARE BENEFITS PLAN [EIN = 541278830]
• EMPLOYEE HEALTH PLAN OF CANTEEN CO. OF N TX, INC. [EIN = 751806298]
• EMPLOYEE HEALTH & WELFARE BENEFIT PROGRAM OF GUGGENHEIM CAPITAL, LLC [EIN = 364358656]
• EMPLOYEE HEALTH PLAN OF MOLLICA SUBS [EIN = 200100308]
• EMPLOYEE HEALTH PLAN OF DOWELL MANAGEMENT [EIN = 421276982]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 621317705]
• EMPLOYEE HEALTH PLAN OF EDN, INC [EIN = 581694140]
• EMPLOYEE HEALTH AND SAFETY PROGRAM [EIN = 362443580]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN [EIN = 521266582]
• EMPLOYEE HEALTH PLAN OF EXCEPTIONAL BRANDS, LLC [EIN = 260905347]
• EMPLOYEE HEALTH PLAN OF A&H PIZZA COMPANIES [EIN = 205204465]
• EMPLOYEE HEALTH PLAN OF J DAVIS ENTERPRISES [EIN = 592883844]
• EMPLOYEE HEALTH INSURANCE FRINGE BENEFITS PLAN SECTION 125 PRE TAX [EIN = 411424025]
• EMPLOYEE HEALTH PLAN OF NEARLY FAMOUS, INC. [EIN = 582362714]
• EMPLOYEE HEALTH PLAN OF CAMPUS KING, INC. [EIN = 860880148]
• EMPLOYEE HEALTH PLAN FOR FERRAN SERVICES & CONTRACTING INC [EIN = 593617819]
• EMPLOYEE HEALTH PLAN OF JPL MANAGEMENT [EIN = 610973818]
• EMPLOYEE HEALTH PLAN OF DEBBIE RENFRO AKA ITS A BUFFALO INC. [EIN = 202989954]
• EMPLOYEE HEALTH BENEFIT PLAN [EIN = 752332791]
• EMPLOYEE HEALTH PLAN OF EAU-D [EIN = 391554756]
• EMPLOYEE HEALTH PLAN OF THE JAN COMPANIES [EIN = 050318793]
• EMPLOYEE HEALTH PLAN OF OSHKOSH RESTAURANTS LLC [EIN = 391938447]
• EMPLOYEE HEALTH PLAN OF STIX & CO, INC. [EIN = 202862405]
• EMPLOYEE HEALTH PLAN OF CAPITAL FAST FOODS LTD. [EIN = 752728846]
• EMPLOYEE HEALTH PLAN OF SUBWAY OF ALASKA, INC [EIN = 920135465]
• EMPLOYEE HEALTH AND TEMPORARY DISABILITY PLAN [EIN = 420279585]
• EMPLOYEE HEALTH PLAN-SHORT TERM DISABILITY [EIN = 462859936]
• EMPLOYEE HEALTH PLAN OF MARTIN FRANCHISE GROUP [EIN = 562142488]
• EMPLOYEE HEALTH PLAN OF AMITA RESTAURANTS [EIN = 611563971]
• EMPLOYEE HEALTH PLAN OF PARKS RESTAURANT MANAGEMENT [EIN = 204496998]
• EMPLOYEE HEALTH PLAN [EIN = 860004538]
• EMPLOYEE HEALTH PLAN OF AMPAL GROUP [EIN = 263773982]
• EMPLOYEE HEALTH PLAN OF SAWTOOTH, INC. [EIN = 030269737]
• EMPLOYEE HEALTH PLAN OF SAVANNAH RESTAURANTS CORP [EIN = 581682762]
• EMPLOYEE HEALTH PLAN OF PHOENIX MGT & CONSULTING [EIN = 650949149]
• EMPLOYEE HEALTH PLAN OF SUPREME FOODS [EIN = 270859771]
• EMPLOYEE HEALTH PLAN OF TENNESSEE OPERATING PARTNERS [EIN = 621789140]
• EMPLOYEE HEALTH PLAN OF BROOKS RESTAURANTS, INC. [EIN = 721112805]
• EMPLOYEE HEALTH PLAN OF WATERVILLE BURGER CORP [EIN = 060990186]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 611273345]
• EMPLOYEE HEALTH AND WELFARE PLAN FOR COLLECTIVE BARGAINING UNIT EMPLOYEES [EIN = 741473579]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 271108379]
• EMPLOYEE HEALTH AND SAFETY BENEFIT PLAN [EIN = 752497104]
• EMPLOYEE HEALTH BENEFIT PLAN [EIN = 580619030]
• EMPLOYEE HEALTH CARE PLAN [EIN = 930499857]
• EMPLOYEE HEALTH, DENTAL & VISION PLAN [EIN = 043294619]
• EMPLOYEE HEALTH PLAN OF DESTINY FOODS, INC [EIN = 742896645]
• EMPLOYEE HEALTH PLAN OF K & JK [EIN = 351798457]
• EMPLOYEE HEALTH PLAN OF JAGETA, INC [EIN = 200683600]
• EMPLOYEE HEALTH PLAN OF SIDMAR MANAGEMENT CORP [EIN = 222221933]
• EMPLOYEE HEALTH PLAN OF CANBY-DENN, INC [EIN = 912127737]
• EMPLOYEE HEALTH PLAN OF MID MISSOURI SUBWAYS [EIN = 431670704]
• EMPLOYEE HEALTH PLAN OF ORWALL INDUSTRIES BK22 [EIN = 590905902]
• EMPLOYEE HEALTH PLAN OF SCORDIA REST. GROUP, INC. [EIN = 311384479]
• EMPLOYEE HEALTH PLAN OF PARS PIES INC DBA DOMINO'S PIZZA [EIN = 472123606]
• EMPLOYEE HEALTH PLAN OF DESCRY CAL, INC [EIN = 330011673]
• EMPLOYEE HEALTH PLAN OF AEQUITAS RESTAURANT HOLDINGS, INC [EIN = 205409051]
• EMPLOYEE HEALTH PLAN OF DELPHIA INC [EIN = 954444896]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PROGRAM OF THE YMCA OF METROPOLITAN CHICAGO [EIN = 362179782]
• EMPLOYEE HEALTH PLAN OF KANE ENTERPRISES, INC [EIN = 061274411]
• EMPLOYEE HEALTH PLAN OF GROUP 2029, INC [EIN = 383691963]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN [EIN = 954297274]
• EMPLOYEE HEALTH AND WELFARE BENEFITS [EIN = 341455539]
• EMPLOYEE HEALTH PLAN OF 24-7 RESTAURANT GROUP, LLC [EIN = 261105173]
• EMPLOYEE HEALTH PLAN OF ROCK KING LLP [EIN = 364008440]
• EMPLOYEE HEALTH PLAN OF WETZEL SUBWAY [EIN = 208490692]
• EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC [EIN = 204618472]
• EMPLOYEE HEALTH PLAN OF LISBON RESTAURANTS INC [EIN = 010318594]
• EMPLOYEE HEALTH PLAN OF MIROOTS, INC. [EIN = 260766629]
• EMPLOYEE HEALTH PROTECTION PLAN FOR JOE N MILES & SONS, INC [EIN = 640411846]
• EMPLOYEE HEALTH PLAN OF D OF ALASKA [EIN = 920057333]
• EMPLOYEE HEALTH PLAN OF ELEVANTA, LLC [EIN = 811548250]
• EMPLOYEE HEALTH PLAN OF LOWCOUNTRY BAGEL, INC [EIN = 208005772]
• EMPLOYEE HEALTH PLAN OF SUMMIT 7, LLC [EIN = 201542718]
• EMPLOYEE HEALTH PLAN OF NOVO OPERATIONS,INC [EIN = 383220616]
• EMPLOYEE HEALTH PLAN OF WINGS WEST ONE, LLC [EIN = 342009112]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN [EIN = 586049575]
• EMPLOYEE HEALTH INSURANCE [EIN = 472124820]
• EMPLOYEE HEALTH PLAN OF RWDT FOODS [EIN = 455037575]
• EMPLOYEE HEALTH PLAN OF R.E. MASSEY [EIN = 742861837]
• EMPLOYEE HEALTH PLAN OF PRYOR & PRYOR, INC. [EIN = 592391734]
• EMPLOYEE HEALTH INSURANCE [EIN = 461293167]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 274634292]
• EMPLOYEE HEALTH INSURANCE [EIN = 810663761]
• EMPLOYEE HEALTH PLAN OF SMASH MANAGEMENT, INC [EIN = 274203417]
• EMPLOYEE HEALTH PLAN OF ARVADA WINGS, LLC DBA BWW 3003 [EIN = 841344256]
• EMPLOYEE HEALTH PLAN OF JOANDY, INC. [EIN = 201188996]
• EMPLOYEE HEALTH INSURANCE [EIN = 461744864]
• EMPLOYEE HEALTH PLAN OF CONSUMER FOOD SERVICES, LLC [EIN = 133847462]
• EMPLOYEE HEALTH PLAN OF YASMIN, INC [EIN = 760267671]
• EMPLOYEE HEALTH PLAN OF PLANET CENTRAL VALLEY, LLC [EIN = 452017990]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 760137985]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 464061915]
• EMPLOYEE HEALTH BENEFIT PLAN FOR THE EMPLOYEES OF PIGGLY WIGGLY ALABAMA DISTRIBUTING COMPANY, INC. [EIN = 630393676]
• EMPLOYEE HEALTH PLAN [EIN = 061497200]
• EMPLOYEE HEALTH PROTECTION PLAN FOR SANDERSON FARMS, INC. AND AFFILIATES [EIN = 640615843]
• EMPLOYEE HEALTH PLAN OF SCREAMIN HOT CONCEPTS, LLC [EIN = 271429889]
• EMPLOYEE HEALTH PLAN OF ATLANTIC COAST FOODS [EIN = 561446090]
• EMPLOYEE HEALTH PLAN OF PFC CLASSIC DINING ORIGINAL [EIN = 352058091]
• EMPLOYEE HEALTH PLAN OF VIGIL VENTURES, INC. [EIN = 752671745]
• EMPLOYEE HEALTH PLAN OF DEVLIN AUTOMOTIVE, INC [EIN = 453042527]
• EMPLOYEE HEALTH PLAN OF RAPID OF EDMOND [EIN = 611533445]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 621474685]
• EMPLOYEE HEALTH PLAN OF TRICO DEVELOPMENT CORP. [EIN = 431177852]
• EMPLOYEE HEALTH PLAN OF ALC HOSPITALITY [EIN = 462369762]
• EMPLOYEE HEALTH PLAN OF DEGEN ENTERPRISES [EIN = 470644864]
• EMPLOYEE HEALTH PLAN OF CAROLINA QUALITY, INC. [EIN = 561506083]
• EMPLOYEE HEALTH PLAN OF SOUTHWIND RESTAURANTS, LLC [EIN = 113669884]
• EMPLOYEE HEALTH PLAN OF FIRST ALBERN FOODS, LTD. [EIN = 561543665]
• EMPLOYEE HEALTH PLAN OF PICTOR ENTERPRISE [EIN = 010941768]
• EMPLOYEE HEALTH PLAN OF NOVA ENGINEERING, PC [EIN = 364370863]
• EMPLOYEE HEALTH PLAN OF JESBON CORP. MANAGEMENT [EIN = 141876271]
• EMPLOYEE HEALTH PLAN OF CARL-CIN BK OFFICE [EIN = 570662065]
• EMPLOYEE HEALTH PLAN OF THE DECK RESTAURANT [EIN = 364351940]
• EMPLOYEE HEALTH PLAN OF SIDMAR MANAGEMENT CORP [EIN = 222221933]
• EMPLOYEE HEALTH PLAN OF HOT PIZZA, INC. [EIN = 752743938]
• EMPLOYEE HEALTH PLAN OF RMH ENTERPRISES, INC. [EIN = 860602878]
• EMPLOYEE HEALTH PLAN OF SHEEHY ENTERPRISES, INC. [EIN = 860318871]
• EMPLOYEE HEALTH PLAN OF GREAT AMERICAN HOLDING COMPANY [EIN = 591833413]
• EMPLOYEE HEALTH PLAN OF CROSSROADS PIZZA, INC. [EIN = 260837907]
• EMPLOYEE HEALTH BENEFIT PLAN [EIN = 130453095]
• EMPLOYEE HEALTH PLAN OF ESTEP & COMPANY CATERING, LLC [EIN = 452609289]
• EMPLOYEE HEALTH PLAN OF KING RESTAURANT MGT [EIN = 860994835]
• EMPLOYEE HEALTH PLAN OF TEXAS SKI RANCH LP [EIN = 742571200]
• EMPLOYEE HEALTH CARE PLAN FOR RIO ALGOM MINING CORP. QUIVERA MINING COMPANY AND AFFILIATE COMPANIES [EIN = 731623282]
• EMPLOYEE HEALTH PLAN OF CLEMENTS MANAGEMENT [EIN = 721488065]
• EMPLOYEE HEALTH PLAN OF ALL AMERICAN FOODS I [EIN = 351431071]
• EMPLOYEE HEALTH PLAN OF GO-BURGER, L.P. [EIN = 200276917]
• EMPLOYEE HEALTH PLAN OF SP FOOD, INC. [EIN = 650482121]
• EMPLOYEE HEALTH PLAN OF GO-BURGER, L.P. [EIN = 200276917]
• EMPLOYEE HEALTH PLAN OF AUDRAIN MEDICAL CENTER [EIN = 431550298]
• EMPLOYEE HEALTH PLAN OF AARON ENTERPRISES [EIN = 621087324]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 621474684]
• EMPLOYEE HEALTH INSURANCE PLAN [EIN = 391681041]
• EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN [EIN = 391243143]
• EMPLOYEE HEALTH PLAN [EIN = 752411095]
• EMPLOYEE HEALTH BENEFIT PLAN AND EMPLOYEE DENTAL BENEFIT PLAN [EIN = 232176124]
• EMPLOYEE HEALTH PLAN OF SMS ENTERPRISES, INC. [EIN = 223116659]
• EMPLOYEE HEALTH PLAN OF STATNY FOODS INC. [EIN = 363367836]
• EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT [EIN = 821762905]
• EMPLOYEE HEALTH PLAN OF S&J ENTERPRISES, LLC [EIN = 542051047]
• EMPLOYEE HEALTH PLAN OF ST JUSTE MANAGEMENT CORP [EIN = 743006345]
• EMPLOYEE HEALTH PLAN OF BARRERAS ENTITIES TEXAS INC [EIN = 742879998]
• EMPLOYEE HEALTH PLAN OF PICTOR ENTERPRISE [EIN = 010941768]
• EMPLOYEE HEALTH PLAN OF DELRIO VENTURE LP [EIN = 474175668]
• EMPLOYEE HEALTH PLAN OF BANTA MANAGEMENT SERVICES, INC [EIN = 141701563]
• EMPLOYEE HEALTH PLAN OF TBAYOU LLC [EIN = 822263506]
• EMPLOYEE HEALTH PLAN OF NOVA ENGINEERING [EIN = 364370863]
• EMPLOYEE HEALTH PLAN OF ZIA FOODS INC [EIN = 461039060]
• EMPLOYEE HEALTH PLAN OF BULLDOG BWW [EIN = 274759500]
• EMPLOYEE HEALTH PLAN OF AD ASTRA II, INC [EIN = 811656488]
• EMPLOYEE HEALTH PLAN OF GROUP ENTERPRISE OF NORTH AMERICA, INC. [EIN = 251495862]
• EMPLOYEE HEALTH PLAN OF MERIDIAN RESTAURANTS UNLIMITED, L.C. [EIN = 223863257]
• EMPLOYEE HEALTH PLAN OF GREEN FOOD 2 GO [EIN = 814113582]
• EMPLOYEE HEALTH PLAN OF ESG HOLDINGS, LLC [EIN = 814726985]
• EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC [EIN = 812076912]
• EMPLOYEE HEALTH PLAN OF DSG KANKAKEE LLC [EIN = 461428147]
• EMPLOYEE HEALTH PLAN OF CEMA, INC [EIN = 310992020]
• EMPLOYEE HEALTH PLAN OF MUFFLERS USA, INC [EIN = 742832536]
• EMPLOYEE HEALTH PLAN OF CORLE BUILDING SYSTEMS, INC. [EIN = 251805260]
• EMPLOYEE HEALTH PLAN OF SHAU MUFFLER OGDEN INC DBA MIDAS [EIN = 362697725]
• EMPLOYEE HEALTH PLAN OF RKB ENTERPRISES, INC [EIN = 382792178]
• EMPLOYEE HEALTH PLAN OF ANDERSON MANAGEMENT GROUP [EIN = 201598467]
• EMPLOYEE HEALTH PLAN OF FLYING S WINGS [EIN = 341883073]
• EMPLOYEE HEALTH PLAN OF CORLE BUILDING SYSTEMS, INC. [EIN = 251805260]
• EMPLOYEE HEALTH PLAN OF SMS CORP OFFICE [EIN = 570439385]
• EMPLOYEE HEALTH PLAN OF SMITH VENDING [EIN = 261365659]
• EMPLOYEE HEALTH PLAN OF RESTAURANT SERVICES, INC. [EIN = 650308534]
• EMPLOYEE HEALTH PLAN OF TEXAS RESTAURANT HOLDINGS LLC [EIN = 831060092]
• EMPLOYEE HEALTH PLAN OF MCJJ HOLDING LLC [EIN = 462809280]
• EMPLOYEE HEALTH PLAN OF WEST SIDE PIZZA PIE LLC [EIN = 263776884]
• EMPLOYEE HEALTH PLAN OF DJD FITNESS NAZARETH INC [EIN = 460862497]
• EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES [EIN = 942580612]
• EMPLOYEE HEALTH PLAN OF NW KINGS LLC [EIN = 814140158]
• EMPLOYEE HEALTH PLAN OF PB FITNESS [EIN = 901013012]
• EMPLOYEE HEALTH PLAN OF MEINEKE CAR CARE 2262,1223 [EIN = 454145514]
• EMPLOYEE HEALTH PLAN OF ANGEL-TECH, INC DBA MINEOLA MIDAS AUTO SERVICES & TIRES [EIN = 261495335]
• EMPLOYEE HEALTH PLAN OF PFIFA DBA PF INDEPENDENT FRANCHISEE COUNCIL [EIN = 471014888]
• EMPLOYEE HEALTH PLAN OF PF DENVER, LLC (PF AURORA) [EIN = 463069462]
• EMPLOYEE HEALTH PLAN OF BERKSHIRE FOOD [EIN = 060905660]
• EMPLOYEE HEALTH PLAN OF BEST OF THE BEST INC DBA SUPERCUTS [EIN = 841646602]
• EMPLOYEE HEALTH PLAN OF RKJ AND SONS, LLC [EIN = 581875890]
• EMPLOYEE HEALTH PLAN OF PF RHODE ISLAND (KIWIMEX) [EIN = 453188880]
• EMPLOYEE HEALTH PLAN OF MID MISSOURI CAR CARE, INC. [EIN = 421761633]
• EMPLOYEE HEALTH PLAN OF GOURMET SUBS OF CHARLOTTE, LLC [EIN = 331138976]
• EMPLOYEE HEALTH PLAN OF THE PROCACCIO CORP [EIN = 412207619]
• EMPLOYEE HEALTH PLAN OF EVOLUTION MANAGEMENT, LLC [EIN = 352614267]
• EMPLOYEE HEALTH PLAN OF MLJ FOODS INC [EIN = 204227833]
• EMPLOYEE HEALTH PLAN OF JEFFREY GIANGRANDE CORPORATION [EIN = 521707974]
• EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC [EIN = 223666724]
• EMPLOYEE HEALTH PLAN OF DONYA CORPORATION [EIN = 820504778]
• EMPLOYEE HEALTH PLAN OF MARCOR LLC DBA MEINEKE [EIN = 273091032]
• EMPLOYEE HEALTH PLAN OF GTM RESTAURANT CORP [EIN = 232108143]
• EMPLOYEE HEALTH PLAN OF NEW KING INC [EIN = 061031059]
• EMPLOYEE HEALTH PLAN OF EMB ENTERPRISE LLC [EIN = 571236293]
• EMPLOYEE HEALTH PLAN OF ROOSTER TAIL INC DBA MEINEKE CAR CARE [EIN = 043087259]
• EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC [EIN = 465445886]
• EMPLOYEE HEALTH PLAN OF SYED RESTAURANTS ENTERPRISES [EIN = 261276014]
• EMPLOYEE HEALTH PLAN OF NATIONAL CITIES CORPORATION I LP [EIN = 813906458]
• EMPLOYEE HEALTH PLAN OF TOTALLY TASTY ENTREES, LLC [EIN = 275418543]
• EMPLOYEE HEALTH PLAN OF CORAL CAY RESTAURANTS LLC [EIN = 471884804]
• EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN [EIN = 831386022]
• EMPLOYEE HEALTH PLAN OF BREW AVENUE REFRESHMENT SVCS [EIN = 262960013]
• EMPLOYEE HEALTH PLAN OF JARDEL ENTERPRISES INC [EIN = 840796459]
• EMPLOYEE HEALTH PLAN OF CAROLINA FRANCHISE HOLDINGS [EIN = 824240401]
• EMPLOYEE HEALTH PLAN OF S & F INVESTMENTS, INC [EIN = 571072521]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 760137035]
• EMPLOYEE HEALTH PLAN OF ATLANTA FAMILY NEUROLOGY PC [EIN = 260376624]
• EMPLOYEE HEALTH PLAN OF ALPHARETTA CARDIOLOGY, LLC [EIN = 582575191]
• EMPLOYEE HEALTH PLAN OF FACTORIAL RESTAURANT HOLDINGS LLC [EIN = 852920023]
• EMPLOYEE HEALTH PLAN OF ATLANTA PSYCHIATRY & PSYCHOTHERAPY ASSOCIATES [EIN = 455348915]
• EMPLOYEE HEALTH PLAN OF COLUMBUS FAMILY MEDICINE LLC [EIN = 814243040]
• EMPLOYEE HEALTH PLAN OF CARDIOLOGY CONSULTANTS OF ATLANTA [EIN = 562529451]
• EMPLOYEE HEALTH PLAN OF ADVANCED INTERNAL MEDICINE [EIN = 300058901]
• EMPLOYEE HEALTH PLAN OF 108 ASSETS LLC [EIN = 824424352]
• EMPLOYEE HEALTH PLAN OF ARCNV INC [EIN = 833436725]
• EMPLOYEE HEALTH PLAN OF FIRST MEDICAL CARE INC [EIN = 581716416]
• EMPLOYEE HEALTH PLAN OF DW AUTOMOTIVE SERVICES INC [EIN = 472123446]
• EMPLOYEE HEALTH PLAN OF ALPHA EYE ASSOCIATES, LLC [EIN = 582498161]
• EMPLOYEE HEALTH PLAN OF JOHNS CREEK SURGERY, PC [EIN = 582636217]
• EMPLOYEE HEALTH PLAN OF CHA OB/GYN PC [EIN = 474056884]
• EMPLOYEE HEALTH PLAN OF PROVIDER OF COMPUTER PROFESSIONALS INC [EIN = 752723411]
• EMPLOYEE HEALTH PLAN OF ATLANTA RHEUMATOLOGY CONSULTANTS [EIN = 260455216]
• EMPLOYEE HEALTH PLAN OF SHEEHY ENTERPRISES, INC. [EIN = 860318871]
• EMPLOYEE HEALTH PLAN OF CENTER FOR DERMATOLOGY LLC [EIN = 264301954]
• EMPLOYEE HEALTH PLAN OF IVY FALLS FAMILY MEDICINE INC [EIN = 203545124]
• EMPLOYEE HEALTH PLAN OF PRIMARY CARE CENTER OF GA, INC [EIN = 582407274]
• EMPLOYEE HEALTH PLAN OF RU HUNGRY LLC [EIN = 550907996]
• EMPLOYEE HEALTH PLAN OF PAUL INTERNAL MEDICINE ASSOCIATES [EIN = 680594620]
• EMPLOYEE HEALTH PLAN OF HUNTSVILLE CAESARS INC [EIN = 203472600]
• EMPLOYEE HEALTH PLAN OF T. TIME INC [EIN = 204105437]
• EMPLOYEE HEALTH PLAN OF CAPRI MEDICAL GROUP [EIN = 263128223]
• EMPLOYEE HEALTH PLAN OF B&A REPAIR CO [EIN = 301003982]
• EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN [EIN = 915893103]
• EMPLOYEE HEALTH CENTRE LLC MEDOVA LIFESTYLE HEALTH PLAN [EIN = 300417858]
• EMPLOYEE HEALTHCARE PLAN [EIN = 010822836]
• EMPLOYEE HEALTH PLAN OF FLATBEC INC [EIN = 203612212]
• EMPLOYEE HEALTH PLAN OF ONE T INC [EIN = 204189481]
• EMPLOYEE HEALTH PLAN OF PF BASELINE FITNESS LLC [EIN = 451503978]
• EMPLOYEE HEALTH PLAN OF MRK ENTERPRISES [EIN = 611132949]
• EMPLOYEE HEALTH PLAN OF BURGER BARN [EIN = 862467626]
• EMPLOYEE HEALTH PLAN OF HAWBROOK HOLDINGS LLC [EIN = 202176503]
• EMPLOYEE HEALTH PLAN OF MODERN OBSTETRICS & GYNECOLOGY OF NORTH ATLANTA [EIN = 272887978]
• EMPLOYEE HEALTH PLAN OF MARK ANTHONY ENTERPRISES [EIN = 621813704]
• EMPLOYEE HEALTH PLAN OF THOMPSON KING HOLDINGS [EIN = 872035125]
• EMPLOYEE HEALTH PLAN OF STB INC [EIN = 611261562]
• EMPLOYEE HEALTH PLAN OF CENTRAL MS ENTERPRISES [EIN = 822683857]
• EMPLOYEE HEALTH PLAN OF SOUTHERN BEHAVIORAL HEALTHCARE, PC [EIN = 043730144]
• EMPLOYEE HEALTH PLAN OF CHI INVESTMENTS [EIN = 431834367]
• EMPLOYEE HEALTH PLAN OF MACHINE CUISINE [EIN = 330976445]
• EMPLOYEE HEALTH PLAN OF ACTIVE ANKLE AND FOOT CARE SPECIALISTS [EIN = 262855885]
• EMPLOYEE HEALTH PLAN OF PURPOSEFUL ADAPTATIONS [EIN = 862263067]
• EMPLOYEE HEALTH PLAN OF BURGERS OF COLUMBIA PIKE [EIN = 621320936]
• EMPLOYEE HEALTH PLAN OF KARVID PARTNERS II, LLC [EIN = 833436581]
• EMPLOYEE HEALTH PLAN OF EXTRA PICKLES [EIN = 842499296]
• EMPLOYEE HEALTH PLAN OF ALBERT F JOHARY MD, PC [EIN = 582421431]
• EMPLOYEE HEALTH PLAN OF ATLANTA ROPHEKA MEDICAL CENTER [EIN = 200540802]
• EMPLOYEE HEALTH PLAN OF CENTER FOR MEDICINE, LLC [EIN = 582356591]
• EMPLOYEE HEALTH PLAN OF PANIMOR CORP [EIN = 831436390]
• EMPLOYEE HEALTH PLAN OF K-H ENTERPRISES [EIN = 470757325]
• EMPLOYEE HEALTH PLAN OF APOLLO BEHAVIOR SERVICES LLC [EIN = 843298073]
• EMPLOYEE HEALTH PLAN OF ST. THERESA'S OB/GYN, INC [EIN = 463240302]
• EMPLOYEE HEALTH PLAN OF HOLDINGS LLC [EIN = 843286472]
• EMPLOYEE HEALTH PLAN OF D&D FOODSERVICE, INC [EIN = 680555829]
• EMPLOYEE HEALTH PLAN OF RGT II INC DBA MEINEKE CAR CARE CENTER [EIN = 471082849]
• EMPLOYEE HEALTH PLAN OF PJ FOODS LLC [EIN = 522127598]
• EMPLOYEE HEALTH PLAN OF CONSOLIDATED BURGER C, LLC [EIN = 822435818]
• EMPLOYEE HEALTH PLAN OF SOUTH ATLANTA VASCULAR INSTITUTE LLC [EIN = 830636051]
• EMPLOYEE HEALTH PLAN OF MAS RESTAURANT GROUP LLC [EIN = 862738243]
• EMPLOYEE HEALTH PLAN OF M SQUARED AZ INC [EIN = 851608911]
• EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC [EIN = 582635783]
• EMPLOYEE HEALTH PLAN OF SIRIPI LLC [EIN = 822970722]
• EMPLOYEE HEALTH PLAN OF EAGLESLANDING DIABETES & ENDOCRINOLOGY [EIN = 300084490]
• EMPLOYEE HEALTH BENEFIT PLAN FOR FIBER OPTIC MANAGEMENT, LLC DBA TURNKEY NETWORK SOLUTIONS [EIN = 263627811]
• EMPLOYEE HEALTH PLAN OF MABAM ENTERPRISES [EIN = 341733393]
• EMPLOYEE HEALTH PLAN OF GRALO [EIN = 043834161]
• EMPLOYEE HEALTH PLAN OF NJ WAX 8 [EIN = 872574869]
• EMPLOYEE HEALTH PLAN OF DANKERT DANKERT ASSOCIATES [EIN = 351889838]
• EMPLOYEE HEALTH PLAN OF TLA SERVICES INC [EIN = 270382943]
• EMPLOYEE HEALTH PLAN OF ALPHA MOTOR WORKS [EIN = 853384519]
• EMPLOYEE HEALTH PLAN OF CARDIOLOGY OF ATLANTA [EIN = 260805667]
• EMPLOYEE HEALTH PLAN OF RENDEZVOUS ENTERPRISES [EIN = 941694577]
• EMPLOYEE HEALTH PLAN OF RIVERDALE FOOT ANKLE AND LEG CLINIC [EIN = 030432582]
• EMPLOYEE HEALTH PLAN OF SBA HOLDINGS INC [EIN = 824878919]
• EMPLOYEE HEALTH PLAN OF SBS HOLDINGS [EIN = 844708174]
• EMPLOYEE HEALTH PLAN OF ALIGN SPINE AND PAIN INSTITUTE LLC [EIN = 871751283]
• EMPLOYEE HEALTH PLAN OF CMH AUTO [EIN = 201166092]
• EMPLOYEE HEALTH PLAN OF ASHLAND ENTERPRISES [EIN = 541903968]
• EMPLOYEE HEALTH AND WELFARE PLAN [EIN = 421727335]
• EMPLOYEE HEALTH PLAN OF RADIANT ONE LLC [EIN = 854045032]
• EMPLOYEE HEALTH PLAN OF VENITA GROUP LLC [EIN = 824202772]
• EMPLOYEE HEALTH PLAN OF BUTLER AUTOMOTIVE [EIN = 462798190]
• EMPLOYEE HEALTH PLAN OF C&A AZ LLC [EIN = 920622329]
• EMPLOYEE HEALTH PLAN OF C3M ENTERPRISES, INC. [EIN = 462975736]
• EMPLOYEE HEALTH PLAN OF COVENANT MEDICAL GROUP [EIN = 822423015]
• EMPLOYEE HEALTH PLAN OF KEM HEALTH [EIN = 850838005]
• EMPLOYEE HEALTH PLAN OF KRYGIER MANAGEMENT, INC. [EIN = 271726124]
• EMPLOYEE HEALTH PLAN OF ROYAL RESTAURANT GROUP [EIN = 921116188]
• EMPLOYEE HEALTH PLAN OF SUNSET SUBWAY [EIN = 860730233]
• EMPLOYEE HEALTH CARE OF WOODBURY CAR CARE DBA MEINEKE CAR CARE #538 [EIN = 825528509]
• EMPLOYEE HEALTH PLAN OF NORTHEAST ATLANTA ENT [EIN = 581949171]