Logo

MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN
Plan identification number 501

MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

MEDICAL AND SURGICAL AFFILIATES INC has sponsored the creation of one or more 401k plans.

Company Name:MEDICAL AND SURGICAL AFFILIATES INC
Employer identification number (EIN):591888833
NAIC Classification:524210
NAIC Description:Insurance Agencies and Brokerages

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-10-01
5012014-10-01
5012013-10-01
5012012-10-01KAREN OLIVER

Plan Statistics for MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN

401k plan membership statisitcs for MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN

Measure Date Value
2015: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01316
Total number of active participants reported on line 7a of the Form 55002015-10-010
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-010
2014: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01366
Total number of active participants reported on line 7a of the Form 55002014-10-01316
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01316
2013: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01565
Total number of active participants reported on line 7a of the Form 55002013-10-01366
Number of retired or separated participants receiving benefits2013-10-010
Total of all active and inactive participants2013-10-01366
2012: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01619
Total number of active participants reported on line 7a of the Form 55002012-10-01558
Number of retired or separated participants receiving benefits2012-10-017
Total of all active and inactive participants2012-10-01565

Form 5500 Responses for MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN

2015: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01This submission is the final filingYes
2015-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: MEDICAL AND SURGICAL AFFILIATES INC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006781362
Policy instance 7
Insurance contract or identification number0006781362
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $32
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-013103
Policy instance 1
Insurance contract or identification number010-013103
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $646
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $646
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number024750
Policy instance 2
Insurance contract or identification number024750
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $197
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066577
Policy instance 3
Insurance contract or identification number066577
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $961
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $961
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066578
Policy instance 4
Insurance contract or identification number066578
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $976
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $976
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066610
Policy instance 5
Insurance contract or identification number066610
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $774
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $774
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number087275
Policy instance 6
Insurance contract or identification number087275
Number of Individuals Covered0
Insurance policy start date2015-10-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $432
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,171
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $432
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-013103
Policy instance 1
Insurance contract or identification number010-013103
Number of Individuals Covered178
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $4,294
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,294
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number024750
Policy instance 2
Insurance contract or identification number024750
Number of Individuals Covered307
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $1,299
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,299
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066577
Policy instance 3
Insurance contract or identification number066577
Number of Individuals Covered57
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $3,067
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,067
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066578
Policy instance 4
Insurance contract or identification number066578
Number of Individuals Covered80
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $4,791
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,791
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066610
Policy instance 5
Insurance contract or identification number066610
Number of Individuals Covered11
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $4,560
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,560
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number087275
Policy instance 6
Insurance contract or identification number087275
Number of Individuals Covered32
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $2,854
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,854
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006781362
Policy instance 7
Insurance contract or identification number0006781362
Number of Individuals Covered11
Insurance policy start date2014-10-01
Insurance policy end date2015-10-01
Total amount of commissions paid to insurance brokerUSD $144
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $144
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006781362
Policy instance 8
Insurance contract or identification number0006781362
Number of Individuals Covered24
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $454
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $454
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number087275
Policy instance 7
Insurance contract or identification number087275
Number of Individuals Covered35
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $3,432
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,432
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberM0752
Policy instance 1
Insurance contract or identification numberM0752
Number of Individuals Covered239
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $110,769
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $110,769
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-013103
Policy instance 2
Insurance contract or identification number010-013103
Number of Individuals Covered305
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $7,461
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,461
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number024750
Policy instance 3
Insurance contract or identification number024750
Number of Individuals Covered346
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $1,365
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,365
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066577
Policy instance 4
Insurance contract or identification number066577
Number of Individuals Covered72
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $2,673
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,673
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066578
Policy instance 5
Insurance contract or identification number066578
Number of Individuals Covered110
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $5,972
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,972
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066610
Policy instance 6
Insurance contract or identification number066610
Number of Individuals Covered11
Insurance policy start date2013-10-01
Insurance policy end date2014-10-01
Total amount of commissions paid to insurance brokerUSD $3,298
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,298
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-013103
Policy instance 2
Insurance contract or identification number010-013103
Number of Individuals Covered453
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $9,150
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,094
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number024750
Policy instance 3
Insurance contract or identification number024750
Number of Individuals Covered408
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $2,099
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,099
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066577
Policy instance 4
Insurance contract or identification number066577
Number of Individuals Covered121
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $4,251
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,251
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066578
Policy instance 5
Insurance contract or identification number066578
Number of Individuals Covered192
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $10,414
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,414
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number066610
Policy instance 6
Insurance contract or identification number066610
Number of Individuals Covered14
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $6,067
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,147
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,067
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number087275
Policy instance 7
Insurance contract or identification number087275
Number of Individuals Covered47
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $4,042
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,042
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0006781362
Policy instance 8
Insurance contract or identification number0006781362
Number of Individuals Covered26
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $1,352
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,352
Insurance broker organization code?3
Insurance broker nameSAM N HOLLOWAY & CO., INC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberM0752
Policy instance 1
Insurance contract or identification numberM0752
Number of Individuals Covered384
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $149,334
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $149,334
Insurance broker organization code?3
Insurance broker nameCOMPASS CONSULTING GROUP

Potentially related plans

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S1