BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE
401k plan membership statisitcs for BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE
| Measure | Date | Value |
|---|
| 2018: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 191 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
| Total of all active and inactive participants | 2018-07-01 | 191 |
| 2017: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 204 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 204 |
| 2016: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 206 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 206 |
| 2015: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 206 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 206 |
| 2014: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 202 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 202 |
| 2013: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 207 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 205 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 205 |
| 2012: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 207 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 207 |
| 2011: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 198 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 205 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
| Total of all active and inactive participants | 2011-07-01 | 205 |
| 2009: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 176 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 176 |
| Total participants | 2009-07-01 | 0 |
| 2018: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Submission has been amended | No |
| 2018-07-01 | This submission is the final filing | No |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-07-01 | Plan is a collectively bargained plan | No |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | Yes |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BRIARCREST CHRISTIAN SCHOOL SYSTEM, INC. LIFE AD&D AND MEDICAL INSURANCE 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 3 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 407 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,338 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 1 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 381 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $10,000 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $223,862 | | Commission paid to Insurance Broker | USD $10,000 | | Amount paid for insurance broker fees | 0 | | 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 | 50012106 |
| Policy instance | 2 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $638 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,335 | | Commission paid to Insurance Broker | USD $638 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 1 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 433 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,147 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 2 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 396 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $10,000 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $222,989 | | Commission paid to Insurance Broker | USD $10,000 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | PAUL BARCROFT |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 3 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $396 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,731 | | Commission paid to Insurance Broker | USD $396 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | INSURANCE AGENT OR BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | REGIONS INSURANCE |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 4 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $4,003 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,028 | | Commission paid to Insurance Broker | USD $4,003 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 3 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 377 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $38,041 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $183,409 | | Commission paid to Insurance Broker | USD $28,041 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | PAUL BARCROFT |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGD606929 |
| Policy instance | 2 |
| Insurance contract or identification number | SGD606929 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $1,541 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,841 | | Commission paid to Insurance Broker | USD $1,541 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 1 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $11,234 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,765 | | Commission paid to Insurance Broker | USD $11,234 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD L. COOK |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 872612G |
| Policy instance | 3 |
| Insurance contract or identification number | 872612G | | Number of Individuals Covered | 202 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,293 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,931 | | Commission paid to Insurance Broker | USD $1,293 | | Additional information about fees paid to insurance broker | BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 2 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 437 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $10,991 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $16,942 | | Commission paid to Insurance Broker | USD $10,991 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 1 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-03 | | Total amount of commissions paid to insurance broker | USD $6,082 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,947 | | Commission paid to Insurance Broker | USD $2,687 | | Additional information about fees paid to insurance broker | BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 3 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 437 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $10,991 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,939 |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 2 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-03 | | Total amount of commissions paid to insurance broker | USD $6,082 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,947 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 872612G |
| Policy instance | 1 |
| Insurance contract or identification number | 872612G | | Number of Individuals Covered | 202 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,293 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,931 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 2 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 381 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $20,934 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,526 | | Commission paid to Insurance Broker | USD $20,934 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 3 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-03 | | Total amount of commissions paid to insurance broker | USD $6,159 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,429 | | Commission paid to Insurance Broker | USD $2,716 | | Additional information about fees paid to insurance broker | BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 1 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 464 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $17,194 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,933 | | Commission paid to Insurance Broker | USD $17,194 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 2 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 471 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $10,482 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,111 | | Commission paid to Insurance Broker | USD $10,482 | | Additional information about fees paid to insurance broker | ACQ/RET | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50012106 |
| Policy instance | 1 |
| Insurance contract or identification number | 50012106 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-03 | | Total amount of commissions paid to insurance broker | USD $6,050 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,748 | | Commission paid to Insurance Broker | USD $2,675 | | Additional information about fees paid to insurance broker | BROKERAGE | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD COOK |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 2 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 460 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $9,978 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,349 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 012018 |
| Policy instance | 1 |
| Insurance contract or identification number | 012018 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $7,819 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $52,127 |
|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 116958 |
| Policy instance | 3 |
| Insurance contract or identification number | 116958 | | Number of Individuals Covered | 441 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $37,399 | | 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 $16,660 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 012018 |
| Policy instance | 2 |
| Insurance contract or identification number | 012018 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $7,497 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,980 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 012018 |
| Policy instance | 1 |
| Insurance contract or identification number | 012018 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $1,026 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,839 |
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