401k Plan data: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN plan

DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan Name	DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN
Plan identification number	501

DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT 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) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

DRMP, INC. F/K/A DYER, RIDDLE, MILLS, & PRECOURT, INC. has sponsored the creation of one or more 401k plans.

Company Name: DRMP, INC. F/K/A DYER, RIDDLE, MILLS, & PRECOURT, INC.

Employer identification number (EIN): 591791174

NAIC Classification: 541330
NAIC Description: Engineering Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-10-01 JESSICA LEARD 2024-10-04
501 2022-10-01 JESSICA LEARD 2024-04-15
501 2021-10-01 TRACIE SAMILLANO 2023-05-22
501 2021-10-01 LAWRENCE SMITH 2023-06-26
501 2020-10-01 LAWRENCE SMITH 2022-07-12
501 2019-10-01 DONALDSON K BARTON JR 2021-07-07
501 2018-10-01 DONALDSON K. BARTON, JR. 2020-06-30
501 2018-10-01 DONALDSON K. BARTON, JR. 2020-06-30
501 2017-10-01
501 2017-10-01
501 2016-10-01
501 2015-10-01
501 2014-10-01
501 2014-01-01
501 2013-01-01
501 2012-01-01 ANDREA BOHR, CAO
501 2011-01-01 ANDREA BOHR, CAO
501 2009-01-01 KENNETH BAYNE, CFO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-10-01	JESSICA LEARD	2024-10-04
501	2022-10-01	JESSICA LEARD	2024-04-15
501	2021-10-01	TRACIE SAMILLANO	2023-05-22
501	2021-10-01	LAWRENCE SMITH	2023-06-26
501	2020-10-01	LAWRENCE SMITH	2022-07-12
501	2019-10-01	DONALDSON K BARTON JR	2021-07-07
501	2018-10-01	DONALDSON K. BARTON, JR.	2020-06-30
501	2018-10-01	DONALDSON K. BARTON, JR.	2020-06-30
501	2017-10-01
501	2017-10-01
501	2016-10-01
501	2015-10-01
501	2014-10-01
501	2014-01-01
501	2013-01-01
501	2012-01-01	ANDREA BOHR, CAO
501	2011-01-01	ANDREA BOHR, CAO
501	2009-01-01	KENNETH BAYNE, CFO

Plan Statistics for DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN

Measure Date Value
2023: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-10-01 429
Total number of active participants reported on line 7a of the Form 5500 2023-10-01 0
Number of retired or separated participants receiving benefits 2023-10-01 0
Number of other retired or separated participants entitled to future benefits 2023-10-01 0
Total of all active and inactive participants 2023-10-01 0
Number of employers contributing to the scheme 2023-10-01 0
2022: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-10-01 573
Total number of active participants reported on line 7a of the Form 5500 2022-10-01 429
Number of retired or separated participants receiving benefits 2022-10-01 15
Number of other retired or separated participants entitled to future benefits 2022-10-01 0
Total of all active and inactive participants 2022-10-01 444
Number of employers contributing to the scheme 2022-10-01 0
2021: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-01 468
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 502
Number of retired or separated participants receiving benefits 2021-10-01 2
Number of other retired or separated participants entitled to future benefits 2021-10-01 5
Total of all active and inactive participants 2021-10-01 509
Number of employers contributing to the scheme 2021-10-01 0
Total participants 2021-10-01 472
2020: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 452
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 438
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-10-01 0
Total participants 2020-10-01 438
Number of participants with account balances 2020-10-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-10-01 0
Number of employers contributing to the scheme 2020-10-01 0
2019: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 448
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 452
Total of all active and inactive participants 2019-10-01 452
Total participants 2019-10-01 452
2018: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 342
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 448
Total of all active and inactive participants 2018-10-01 448
Total participants 2018-10-01 448
2017: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 342
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 342
Total of all active and inactive participants 2017-10-01 342
Total participants 2017-10-01 342
2016: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 287
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 342
Total of all active and inactive participants 2016-10-01 342
Total participants 2016-10-01 342
2015: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 263
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 287
Total of all active and inactive participants 2015-10-01 287
2014: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 218
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 263
Total of all active and inactive participants 2014-10-01 263
Total participants, beginning-of-year 2014-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 218
Total of all active and inactive participants 2014-01-01 218
2013: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 218
Total of all active and inactive participants 2013-01-01 218
2012: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 215
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 209
Total of all active and inactive participants 2012-01-01 209
2011: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 256
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 215
Total of all active and inactive participants 2011-01-01 215
2009: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 327
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 269
Total of all active and inactive participants 2009-01-01 269

Measure	Date	Value
2023: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-10-01	429
Total number of active participants reported on line 7a of the Form 5500	2023-10-01	0
Number of retired or separated participants receiving benefits	2023-10-01	0
Number of other retired or separated participants entitled to future benefits	2023-10-01	0
Total of all active and inactive participants	2023-10-01	0
Number of employers contributing to the scheme	2023-10-01	0
2022: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-10-01	573
Total number of active participants reported on line 7a of the Form 5500	2022-10-01	429
Number of retired or separated participants receiving benefits	2022-10-01	15
Number of other retired or separated participants entitled to future benefits	2022-10-01	0
Total of all active and inactive participants	2022-10-01	444
Number of employers contributing to the scheme	2022-10-01	0
2021: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	468
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	502
Number of retired or separated participants receiving benefits	2021-10-01	2
Number of other retired or separated participants entitled to future benefits	2021-10-01	5
Total of all active and inactive participants	2021-10-01	509
Number of employers contributing to the scheme	2021-10-01	0
Total participants	2021-10-01	472
2020: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	452
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	438
Number of retired or separated participants receiving benefits	2020-10-01	0
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	438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-10-01	0
Total participants	2020-10-01	438
Number of participants with account balances	2020-10-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-10-01	0
Number of employers contributing to the scheme	2020-10-01	0
2019: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	448
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	452
Total of all active and inactive participants	2019-10-01	452
Total participants	2019-10-01	452
2018: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	342
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	448
Total of all active and inactive participants	2018-10-01	448
Total participants	2018-10-01	448
2017: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	342
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	342
Total of all active and inactive participants	2017-10-01	342
Total participants	2017-10-01	342
2016: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	287
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	342
Total of all active and inactive participants	2016-10-01	342
Total participants	2016-10-01	342
2015: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	263
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	287
Total of all active and inactive participants	2015-10-01	287
2014: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	218
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	263
Total of all active and inactive participants	2014-10-01	263
Total participants, beginning-of-year	2014-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	218
Total of all active and inactive participants	2014-01-01	218
2013: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	218
Total of all active and inactive participants	2013-01-01	218
2012: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	215
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	209
Total of all active and inactive participants	2012-01-01	209
2011: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	256
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	215
Total of all active and inactive participants	2011-01-01	215
2009: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	327
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	269
Total of all active and inactive participants	2009-01-01	269

Form 5500 Responses for DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN

2023: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2023 form 5500 responses
2023-10-01	Type of plan entity	Single employer plan
2023-10-01	This submission is the final filing	Yes
2023-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-10-01	Plan funding arrangement – Insurance	Yes
2023-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-10-01	Plan benefit arrangement – Insurance	Yes
2023-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2022 form 5500 responses
2022-10-01	Type of plan entity	Single employer plan
2022-10-01	Plan funding arrangement – Insurance	Yes
2022-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-10-01	Plan benefit arrangement – Insurance	Yes
2022-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
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: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2019: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2018: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	Yes
2018-10-01	Plan funding arrangement – Insurance	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2017: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	Yes
2017-10-01	Plan funding arrangement – Insurance	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2016: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	Yes
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	Yes
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: DYER RIDDLE MILLS & PRECOURT FLEXIBLE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

530415

Policy instance

Insurance contract or identification number	530415
Number of Individuals Covered	206
Insurance policy start date	2023-10-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $8,036
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $6,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	431
Insurance policy start date	2023-10-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $-124
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,527,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

346

Policy instance

Insurance contract or identification number	346
Number of Individuals Covered	13
Insurance policy start date	2023-10-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $653
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	573
Insurance policy start date	2023-10-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,154
Total amount of fees paid to insurance company	USD $4,395
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

530415

Policy instance

Insurance contract or identification number	530415
Number of Individuals Covered	202
Insurance policy start date	2022-10-01
Insurance policy end date	2023-09-30
Total amount of commissions paid to insurance broker	USD $16,948
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $70,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,123
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

346

Policy instance

Insurance contract or identification number	346
Number of Individuals Covered	13
Insurance policy start date	2022-10-01
Insurance policy end date	2023-09-30
Total amount of commissions paid to insurance broker	USD $4,353
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $145,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,353
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	419
Insurance policy start date	2022-10-01
Insurance policy end date	2023-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $183,649
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,246,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	183649
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	563
Insurance policy start date	2022-10-01
Insurance policy end date	2023-09-30
Total amount of commissions paid to insurance broker	USD $47,321
Total amount of fees paid to insurance company	USD $29,847
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,377
Amount paid for insurance broker fees	29847
Additional information about fees paid to insurance broker	CONTINGENT COMPENSATION, ADMINISTRATIVE
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	353
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $157,499
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,464,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	157499
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS, INCENTIVE COMPENSATION
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

346

Policy instance

Insurance contract or identification number	346
Number of Individuals Covered	21
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $5,449
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $181,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,449
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

530415

Policy instance

Insurance contract or identification number	530415
Number of Individuals Covered	170
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $14,420
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $60,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,016
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	472
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $43,630
Total amount of fees paid to insurance company	USD $23,809
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
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, EMPLOYEE ASSISTANCE PROGRAM
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,630
Amount paid for insurance broker fees	23809
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	353
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of fees paid to insurance company	USD $156,284
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,464,569
Amount paid for insurance broker fees	156284
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	335
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $27,002
Total amount of fees paid to insurance company	USD $10,801
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,002
Amount paid for insurance broker fees	10801
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	472
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $4,356
Total amount of fees paid to insurance company	USD $5,102
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,356
Amount paid for insurance broker fees	5102
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	21
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $5,449
Welfare Benefit Premiums Paid to Carrier	USD $181,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,449
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	290
Insurance policy start date	2021-01-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $3,690
Total amount of fees paid to insurance company	USD $1,476
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,690
Amount paid for insurance broker fees	1476
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00530415

Policy instance

Insurance contract or identification number	00530415
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $14,419
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	VWB (ACC, CI)
Welfare Benefit Premiums Paid to Carrier	USD $60,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,016
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	182
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
Total amount of commissions paid to insurance broker	USD $3,814
Total amount of fees paid to insurance company	USD $3,608
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,814
Amount paid for insurance broker fees	3608
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	189
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $4,478
Total amount of fees paid to insurance company	USD $3,469
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,478
Amount paid for insurance broker fees	3469
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	329
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of fees paid to insurance company	USD $144,663
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,132,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	144663
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	308
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $28,025
Total amount of fees paid to insurance company	USD $10,398
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,025
Amount paid for insurance broker fees	10398
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	438
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $5,150
Total amount of fees paid to insurance company	USD $4,652
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,150
Amount paid for insurance broker fees	4652
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	168
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $5,192
Total amount of fees paid to insurance company	USD $2,548
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,192
Amount paid for insurance broker fees	2548
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	30
Insurance policy start date	2020-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $6,660
Welfare Benefit Premiums Paid to Carrier	USD $220,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,660
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00530415

Policy instance

Insurance contract or identification number	00530415
Number of Individuals Covered	156
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $13,856
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	VWB (ACC, CI)
Welfare Benefit Premiums Paid to Carrier	USD $57,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,547
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	254
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
Total amount of commissions paid to insurance broker	USD $3,637
Total amount of fees paid to insurance company	USD $1,340
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,637
Amount paid for insurance broker fees	1340
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	318
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $147,142
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,176,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,142
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	298
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $25,497
Total amount of fees paid to insurance company	USD $9,817
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,497
Amount paid for insurance broker fees	9817
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	452
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $4,850
Total amount of fees paid to insurance company	USD $4,265
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,850
Amount paid for insurance broker fees	4265
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	164
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $5,078
Total amount of fees paid to insurance company	USD $2,544
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,078
Amount paid for insurance broker fees	2544
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	202
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $4,450
Total amount of fees paid to insurance company	USD $3,561
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,450
Amount paid for insurance broker fees	3561
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	26
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $5,630
Welfare Benefit Premiums Paid to Carrier	USD $174,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,630
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00530415

Policy instance

Insurance contract or identification number	00530415
Number of Individuals Covered	159
Insurance policy start date	2019-01-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $13,610
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	VWB (ACC, CI)
Welfare Benefit Premiums Paid to Carrier	USD $57,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,294
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	246
Insurance policy start date	2019-10-01
Insurance policy end date	2020-09-30
Total amount of commissions paid to insurance broker	USD $3,395
Total amount of fees paid to insurance company	USD $1,222
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,395
Amount paid for insurance broker fees	1222
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	307
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $134,583
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,827,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $134,583
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	283
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $22,065
Total amount of fees paid to insurance company	USD $8,386
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,065
Amount paid for insurance broker fees	8386
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	448
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $5,195
Total amount of fees paid to insurance company	USD $4,287
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,195
Amount paid for insurance broker fees	4287
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	177
Insurance policy start date	2018-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $5,365
Total amount of fees paid to insurance company	USD $2,692
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,365
Amount paid for insurance broker fees	2692
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	214
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $4,274
Total amount of fees paid to insurance company	USD $3,097
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,274
Amount paid for insurance broker fees	3097
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00530415

Policy instance

Insurance contract or identification number	00530415
Number of Individuals Covered	241
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $15,809
Total amount of fees paid to insurance company	USD $3,210
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	VWB (ACC, CI)
Welfare Benefit Premiums Paid to Carrier	USD $79,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,615
Amount paid for insurance broker fees	3210
Insurance broker organization code?	3

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	23
Insurance policy start date	2018-10-01
Insurance policy end date	2019-09-30
Total amount of commissions paid to insurance broker	USD $4,431
Welfare Benefit Premiums Paid to Carrier	USD $149,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,431
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00530415

Policy instance

Insurance contract or identification number	00530415
Number of Individuals Covered	198
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $12,607
Total amount of fees paid to insurance company	USD $2,496
Vision Insurance Welfare Benefit	Yes
Other welfare benefits provided	VWB (ACC, CI)
Welfare Benefit Premiums Paid to Carrier	USD $63,214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	22
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $4,238
Welfare Benefit Premiums Paid to Carrier	USD $143,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	179
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $7,122
Total amount of fees paid to insurance company	USD $5,077
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	148
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $9,559
Total amount of fees paid to insurance company	USD $4,262
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	342
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $8,060
Total amount of fees paid to insurance company	USD $6,741
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	244
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of commissions paid to insurance broker	USD $19,542
Total amount of fees paid to insurance company	USD $7,502
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	270
Insurance policy start date	2017-10-01
Insurance policy end date	2018-09-30
Total amount of fees paid to insurance company	USD $122,521
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,487,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	108
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $2,590
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,851
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	153
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $5,415
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,395
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	17
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $2,208
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $68,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,208
Insurance broker organization code?	3
Insurance broker name	HARDY VAUGHN

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	122
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $5,990
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,384
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	263
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $6,072
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,587
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	183
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $16,368
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,661
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	207
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $96,531
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,757,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC (THE)

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )

Policy contract number

8496686

Policy instance

Insurance contract or identification number	8496686
Number of Individuals Covered	48
Insurance policy start date	2014-10-30
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $803
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	VWB ACC, CI
Welfare Benefit Premiums Paid to Carrier	USD $15,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $783
Insurance broker organization code?	3
Insurance broker name	NP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	189
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $15,155
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,080
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	256
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $4,531
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,648
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	107
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $4,917
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,291
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	14
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $1,768
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $60,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,768
Insurance broker organization code?	3
Insurance broker name	HARDY VAUGHN

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )

Policy contract number

8496686

Policy instance

Insurance contract or identification number	8496686
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,176
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	VWB ACC, CI
Welfare Benefit Premiums Paid to Carrier	USD $16,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,159
Insurance broker organization code?	3
Insurance broker name	NP INSURANCE SERVICES INC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	215
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $149,072
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,331,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC (THE)

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	134
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $4,050
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,298
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	110
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $2,058
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,797
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )

Policy contract number

8496686

Policy instance

Insurance contract or identification number	8496686
Number of Individuals Covered	51
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $619
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	VWB ACC, CI
Welfare Benefit Premiums Paid to Carrier	USD $15,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $534
Insurance broker organization code?	3
Insurance broker name	NP INSURANCE SERVICES INC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	183
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $-62
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,235,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $-62
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC (THE)

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	156
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $13,813
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,770
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	98
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $4,351
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,769
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	12
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $1,630
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $54,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,630
Insurance broker organization code?	3
Insurance broker name	HARDY VAUGHN

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	120
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $2,588
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,168
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	89
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $1,571
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,350
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	218
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $3,786
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,953
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	140
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $13,933
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,933
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	209
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $4,402
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,516
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	102
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $4,720
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,142
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )

Policy contract number

00346

Policy instance

Insurance contract or identification number	00346
Number of Individuals Covered	11
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $1,363
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $44,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,363
Insurance broker organization code?	3
Insurance broker name	HARDY VAUGHN

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	67
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $1,639
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,428
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )

Policy contract number

8496686

Policy instance

Insurance contract or identification number	8496686
Number of Individuals Covered	66
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,658
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	VWB ACC, CI
Welfare Benefit Premiums Paid to Carrier	USD $18,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,485
Insurance broker organization code?	3
Insurance broker name	ELBERT VAUGHN

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	64
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $2,683
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,258
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	170
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $61,633
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,054,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $61,633
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC (THE)

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	156
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $13,871
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
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

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	188
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $66,044
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,201,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	215
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $4,168
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	109
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $4,583
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	125
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $4,021
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	256
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $4,565
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

145742

Policy instance

Insurance contract or identification number	145742
Number of Individuals Covered	181
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $14,282
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
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

3212244

Policy instance

Insurance contract or identification number	3212244
Number of Individuals Covered	221
Insurance policy start date	2009-10-01
Insurance policy end date	2010-09-30
Total amount of commissions paid to insurance broker	USD $74,946
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,496,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	DRMP, INC. F/K/A DYER, RIDDLE, MILLS, & PRECOURT, INC.
Employer identification number (EIN):	591791174
NAIC Classification:	541330
NAIC Description:	Engineering Services