TENNESSEE EDUCATION ASSOCIATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN
401k plan membership statisitcs for TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 51 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 60 |
| Total of all active and inactive participants | 2022-01-01 | 111 |
| Total participants | 2022-01-01 | 111 |
| 2021: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 94 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 48 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 38 |
| Total of all active and inactive participants | 2021-01-01 | 86 |
| Total participants | 2021-01-01 | 86 |
| 2020: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 52 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 42 |
| Total of all active and inactive participants | 2020-01-01 | 94 |
| Total participants | 2020-01-01 | 94 |
| 2019: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 142 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 42 |
| Total of all active and inactive participants | 2019-01-01 | 184 |
| Total participants | 2019-01-01 | 184 |
| 2018: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 204 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 42 |
| Total of all active and inactive participants | 2018-01-01 | 246 |
| Total participants | 2018-01-01 | 246 |
| 2017: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 272 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 41 |
| Total of all active and inactive participants | 2017-01-01 | 313 |
| Total participants | 2017-01-01 | 313 |
| 2016: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 317 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 272 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 41 |
| Total of all active and inactive participants | 2016-01-01 | 313 |
| Total participants | 2016-01-01 | 313 |
| 2015: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 347 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 272 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 45 |
| Total of all active and inactive participants | 2015-01-01 | 317 |
| Total participants | 2015-01-01 | 0 |
| 2014: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 335 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 302 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 45 |
| Total of all active and inactive participants | 2014-01-01 | 347 |
| Total participants | 2014-01-01 | 0 |
| 2013: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 366 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 294 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 41 |
| Total of all active and inactive participants | 2013-01-01 | 335 |
| Total participants | 2013-01-01 | 0 |
| 2012: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 379 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 324 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 42 |
| Total of all active and inactive participants | 2012-01-01 | 366 |
| Total participants | 2012-01-01 | 0 |
| 2011: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 369 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 339 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 40 |
| Total of all active and inactive participants | 2011-01-01 | 379 |
| Total participants | 2011-01-01 | 379 |
| 2009: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 382 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 334 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 32 |
| Total of all active and inactive participants | 2009-01-01 | 366 |
| Total participants | 2009-01-01 | 366 |
| 2022: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan is a collectively bargained plan | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan is a collectively bargained plan | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan is a collectively bargained plan | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan is a collectively bargained plan | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan is a collectively bargained plan | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan is a collectively bargained plan | Yes |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan is a collectively bargained plan | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan is a collectively bargained plan | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: TENN. EDUCATION ASSOCIATION FLEXIBLE BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan is a collectively bargained plan | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,031,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2023-01-01 | | Total amount of commissions paid to insurance broker | USD $3,037 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $25,012 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,037 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2023-01-01 | | Total amount of commissions paid to insurance broker | USD $4,795 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | FLEX ADD, FLEX LIFE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $47,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,795 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $819,857 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $3,649 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,739 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,649 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2022-01-01 | | Total amount of commissions paid to insurance broker | USD $3,649 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $57,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,649 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $5,586 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $55,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,586 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $3,055 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,114 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,055 | | Insurance broker organization code? | 3 |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $907,164 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $5,825 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $58,255 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,825 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $988,058 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-07-01 | | Total amount of commissions paid to insurance broker | USD $6,145 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $56,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,145 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-07-01 | | Total amount of commissions paid to insurance broker | USD $3,244 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,977 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,244 | | Insurance broker organization code? | 3 |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,055,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 4 |
| Insurance contract or identification number | ABL405228 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-07-01 | | Total amount of commissions paid to insurance broker | USD $607 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,046 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $607 | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH-MCDOWELL INSURANCE |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 3 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,015,525 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-07-01 | | Total amount of commissions paid to insurance broker | USD $6,184 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $63,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,184 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-07-01 | | Total amount of commissions paid to insurance broker | USD $3,196 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,196 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS INC |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 4 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,107,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-07-01 | | Total amount of commissions paid to insurance broker | USD $7,482 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $74,860 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,482 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 2 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-07-01 | | Total amount of commissions paid to insurance broker | USD $3,220 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,887 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,220 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 3 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $5,350 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,757 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,925 | | Insurance broker organization code? | 3 | | Insurance broker name | CHERYL GREEN |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 3 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-07-01 | | Total amount of commissions paid to insurance broker | USD $3,131 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,622 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,131 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-07-01 | | Total amount of commissions paid to insurance broker | USD $7,555 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $81,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,555 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 2 |
| Insurance contract or identification number | ABL405228 | | Number of Individuals Covered | 302 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-07-01 | | Total amount of commissions paid to insurance broker | USD $175 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $175 | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH-MCDOWELL INSURANCE AGENCY |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 4 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 179 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $5,502 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,050 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,502 | | Insurance broker organization code? | 3 | | Insurance broker name | CHERYL GREEN |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 5 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,074,233 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 5 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,098,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 3 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-07-01 | | Total amount of commissions paid to insurance broker | USD $2,824 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,813 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,824 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 2 |
| Insurance contract or identification number | ABL405228 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-07-01 | | Total amount of commissions paid to insurance broker | USD $300 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $300 | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH-MCDOWELL INSURANCE AGENCY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 1 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 97 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-07-01 | | Total amount of commissions paid to insurance broker | USD $7,804 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $78,039 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,804 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC. |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 4 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $5,720 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,720 | | Insurance broker organization code? | 3 | | Insurance broker name | CHERYL GREEN |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 5 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-07-01 | | Total amount of commissions paid to insurance broker | USD $8,056 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $80,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,056 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 4 |
| Insurance contract or identification number | ABL405228 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-07-01 | | Total amount of commissions paid to insurance broker | USD $300 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $300 | | Insurance broker organization code? | 3 | | Insurance broker name | BUSH-MCDOWELL INSURANCE AGENCY |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 3 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-07-01 | | Total amount of commissions paid to insurance broker | USD $3,366 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,052 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,366 | | Insurance broker organization code? | 3 | | Insurance broker name | BENEFIT CONSULTANTS, INC |
|
| TENNESSEE STATE GOVERNMENT INSURANCE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 2498662 |
| Policy instance | 1 |
| Insurance contract or identification number | 2498662 | | Number of Individuals Covered | 79 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,166,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 2 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $5,227 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,227 | | Insurance broker organization code? | 3 | | Insurance broker name | CHERYL GREEN |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 5 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-07-01 | | Total amount of commissions paid to insurance broker | USD $8,718 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $87,177 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 2 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $5,420 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,399 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 3 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2012-01-01 | | Total amount of commissions paid to insurance broker | USD $3,407 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 150998 |
| Policy instance | 1 |
| Insurance contract or identification number | 150998 | | Number of Individuals Covered | 195 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $80,438 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,472,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 4 |
| Insurance contract or identification number | ABL405228 | | Number of Individuals Covered | 339 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-07-01 | | Total amount of commissions paid to insurance broker | USD $300 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 522843 |
| Policy instance | 3 |
| Insurance contract or identification number | 522843 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2011-01-01 | | Total amount of commissions paid to insurance broker | USD $3,495 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL405228 |
| Policy instance | 4 |
| Insurance contract or identification number | ABL405228 | | Number of Individuals Covered | 335 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-07-01 | | Total amount of commissions paid to insurance broker | USD $351 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,339 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 523654 |
| Policy instance | 5 |
| Insurance contract or identification number | 523654 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-07-01 | | Total amount of commissions paid to insurance broker | USD $8,556 | | Total amount of fees paid to insurance company | USD $496 | | Other welfare benefits provided | FLEX AD&D & LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $85,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 150998 |
| Policy instance | 1 |
| Insurance contract or identification number | 150998 | | Number of Individuals Covered | 199 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-06-30 | | Total amount of commissions paid to insurance broker | USD $78,208 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,698,068 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 83544 |
| Policy instance | 2 |
| Insurance contract or identification number | 83544 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2009-07-01 | | Insurance policy end date | 2010-06-30 | | Total amount of commissions paid to insurance broker | USD $5,425 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
