L.B.J. & C DEVELOPMENT CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL
401k plan membership statisitcs for L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL
| Measure | Date | Value |
|---|
| 2022: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-05-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 232 |
| Total of all active and inactive participants | 2022-05-01 | 232 |
| 2021: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-05-01 | 237 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 227 |
| Total of all active and inactive participants | 2021-05-01 | 227 |
| 2020: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 214 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 237 |
| Total of all active and inactive participants | 2020-05-01 | 237 |
| 2019: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 214 |
| Total of all active and inactive participants | 2019-05-01 | 214 |
| 2018: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-05-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 183 |
| Total of all active and inactive participants | 2018-05-01 | 183 |
| 2017: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-05-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 202 |
| Total of all active and inactive participants | 2017-05-01 | 202 |
| 2016: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-05-01 | 200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 202 |
| Total of all active and inactive participants | 2016-05-01 | 202 |
| 2015: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-05-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 200 |
| Total of all active and inactive participants | 2015-05-01 | 200 |
| Total participants | 2015-05-01 | 200 |
| 2014: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-05-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 201 |
| Total of all active and inactive participants | 2014-05-01 | 201 |
| 2013: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-05-01 | 220 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 213 |
| Total of all active and inactive participants | 2013-05-01 | 213 |
| 2012: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-05-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 220 |
| Total of all active and inactive participants | 2012-05-01 | 220 |
| 2011: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-05-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 223 |
| Total of all active and inactive participants | 2011-05-01 | 223 |
| 2022: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2022 form 5500 responses |
|---|
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2021 form 5500 responses |
|---|
| 2021-05-01 | Type of plan entity | Single employer plan |
| 2021-05-01 | Plan funding arrangement – Insurance | Yes |
| 2021-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2020 form 5500 responses |
|---|
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2019 form 5500 responses |
|---|
| 2019-05-01 | Type of plan entity | Single employer plan |
| 2019-05-01 | Plan funding arrangement – Insurance | Yes |
| 2019-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2018 form 5500 responses |
|---|
| 2018-05-01 | Type of plan entity | Single employer plan |
| 2018-05-01 | Plan funding arrangement – Insurance | Yes |
| 2018-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2017 form 5500 responses |
|---|
| 2017-05-01 | Type of plan entity | Single employer plan |
| 2017-05-01 | Plan funding arrangement – Insurance | Yes |
| 2017-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2016 form 5500 responses |
|---|
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2015 form 5500 responses |
|---|
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2014 form 5500 responses |
|---|
| 2014-05-01 | Type of plan entity | Single employer plan |
| 2014-05-01 | Plan funding arrangement – Insurance | Yes |
| 2014-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2013 form 5500 responses |
|---|
| 2013-05-01 | Type of plan entity | Single employer plan |
| 2013-05-01 | Plan funding arrangement – Insurance | Yes |
| 2013-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2012 form 5500 responses |
|---|
| 2012-05-01 | Type of plan entity | Single employer plan |
| 2012-05-01 | Plan funding arrangement – Insurance | Yes |
| 2012-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: L. B. J. & C. DEVELOPMENT CORPORATION CAFETERIA PL 2011 form 5500 responses |
|---|
| 2011-05-01 | Type of plan entity | Single employer plan |
| 2011-05-01 | First time form 5500 has been submitted | Yes |
| 2011-05-01 | Plan funding arrangement – Insurance | Yes |
| 2011-05-01 | Plan benefit arrangement – Insurance | Yes |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $2,198 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $13,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,291 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $1,977 | | Total amount of fees paid to insurance company | USD $256 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,801 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,337 | | Amount paid for insurance broker fees | 256 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $70,241 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,428 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70,241 | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $2,260 | | Total amount of fees paid to insurance company | USD $33 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $17,468 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,210 | | Amount paid for insurance broker fees | 23 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $2,199 | | Total amount of fees paid to insurance company | USD $282 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,076 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,495 | | Amount paid for insurance broker fees | 282 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $71,333 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,333 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $71,284 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,284 | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $2,260 | | Total amount of fees paid to insurance company | USD $292 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,528 | | Amount paid for insurance broker fees | 292 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $3,079 | | Total amount of fees paid to insurance company | USD $32 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $20,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,731 | | Amount paid for insurance broker fees | 23 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $2,994 | | Total amount of fees paid to insurance company | USD $21 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $22,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,611 | | Amount paid for insurance broker fees | 15 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $2,203 | | Total amount of fees paid to insurance company | USD $282 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,497 | | Amount paid for insurance broker fees | 282 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $67,255 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,255 | | Additional information about fees paid to insurance broker | ACQ / RET | | Insurance broker organization code? | 3 |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $3,693 | | Total amount of fees paid to insurance company | USD $167 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $25,139 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,057 | | Amount paid for insurance broker fees | 119 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $61,587 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,704 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61,587 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $2,688 | | Total amount of fees paid to insurance company | USD $313 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,906 | | Amount paid for insurance broker fees | 313 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $1,840 | | Total amount of fees paid to insurance company | USD $244 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $5,635 | | Total amount of fees paid to insurance company | USD $327 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $30,369 | | 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 | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 219 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $53,085 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,727 | | 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 | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $63,971 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,971 | | Insurance broker organization code? | 3 | | Insurance broker name | LARRY SPROUSE |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $2,412 | | Total amount of fees paid to insurance company | USD $292 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,683 | | Amount paid for insurance broker fees | 292 | | Insurance broker name | LARRY SPROUSE |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $4,923 | | Total amount of fees paid to insurance company | USD $234 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $28,554 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,688 | | Amount paid for insurance broker fees | 146 | | Insurance broker name | RONALD H RICHEY |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $6,216 | | Total amount of fees paid to insurance company | USD $154 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $29,536 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,440 | | Amount paid for insurance broker fees | 96 | | Insurance broker name | RONALD E KIRKLAND |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $2,151 | | Total amount of fees paid to insurance company | USD $273 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,469 | | Amount paid for insurance broker fees | 273 | | Insurance broker name | LARRY SPROUSE |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $56,821 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,821 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | LARRY SPROUSE |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $59,317 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,842 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,427 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | DENNIS KONIK |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MV494 |
| Policy instance | 3 |
| Insurance contract or identification number | MV494 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $5,634 | | Total amount of fees paid to insurance company | USD $35 | | Other welfare benefits provided | CANCER, INTENSIVE CARE, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $28,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,218 | | Amount paid for insurance broker fees | 22 | | Insurance broker name | JACKIE A WRIGHT |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $2,221 | | Total amount of fees paid to insurance company | USD $286 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,287 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,507 | | Amount paid for insurance broker fees | 286 | | Insurance broker name | LARRY SPROUSE |
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| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50002605 |
| Policy instance | 2 |
| Insurance contract or identification number | 50002605 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $1,928 | | Total amount of fees paid to insurance company | USD $263 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,164 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,270 | | Amount paid for insurance broker fees | 263 | | Insurance broker name | LARRY SPROUSE |
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| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 92166 |
| Policy instance | 1 |
| Insurance contract or identification number | 92166 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $67,230 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,894 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,230 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | DENNIS KONIK |
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