CHUCK HUTTON CHEVROLET COMPANY CAFETERIA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN
401k plan membership statisitcs for CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN
Measure | Date | Value |
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2021: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-08-01 | 292 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-08-01 | 281 |
Total of all active and inactive participants | 2021-08-01 | 281 |
2020: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-08-01 | 323 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-08-01 | 292 |
Total of all active and inactive participants | 2020-08-01 | 292 |
2019: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-08-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-08-01 | 323 |
Total of all active and inactive participants | 2019-08-01 | 323 |
2018: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-08-01 | 302 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-08-01 | 289 |
Total of all active and inactive participants | 2018-08-01 | 289 |
2017: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-08-01 | 343 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-08-01 | 302 |
Total of all active and inactive participants | 2017-08-01 | 302 |
2016: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-08-01 | 204 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-08-01 | 343 |
Total of all active and inactive participants | 2016-08-01 | 343 |
2015: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-08-01 | 209 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-08-01 | 204 |
Total of all active and inactive participants | 2015-08-01 | 204 |
2014: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-08-01 | 203 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-08-01 | 209 |
Total of all active and inactive participants | 2014-08-01 | 209 |
2013: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-08-01 | 232 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-08-01 | 196 |
Total of all active and inactive participants | 2013-08-01 | 196 |
2012: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-08-01 | 122 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-08-01 | 232 |
Number of retired or separated participants receiving benefits | 2012-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-08-01 | 0 |
Total of all active and inactive participants | 2012-08-01 | 232 |
2011: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-08-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-08-01 | 122 |
Total of all active and inactive participants | 2011-08-01 | 122 |
2010: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-08-01 | 114 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-08-01 | 123 |
Number of retired or separated participants receiving benefits | 2010-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-08-01 | 0 |
Total of all active and inactive participants | 2010-08-01 | 123 |
2009: CHUCK HUTTON CHEVROLET CO. CAFETERIA PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-08-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-08-01 | 114 |
Total of all active and inactive participants | 2009-08-01 | 114 |
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | KNG75 |
Policy instance | 6 |
Insurance contract or identification number | KNG75 | Number of Individuals Covered | 73 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $11,901 | Total amount of fees paid to insurance company | USD $78 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,949 | Amount paid for insurance broker fees | 53 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | P3068 |
Policy instance | 5 |
Insurance contract or identification number | P3068 | Number of Individuals Covered | 98 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $49,640 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,640 | Insurance broker organization code? | 3 |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00633201 |
Policy instance | 4 |
Insurance contract or identification number | 00633201 | Number of Individuals Covered | 134 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $7,316 | Total amount of fees paid to insurance company | USD $38,164 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,316 | Amount paid for insurance broker fees | 38164 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 82-2723296 |
Policy instance | 3 |
Insurance contract or identification number | 82-2723296 | Number of Individuals Covered | 74 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $6,060 | Total amount of fees paid to insurance company | USD $32 | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,153 | Amount paid for insurance broker fees | 26 | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 8100578326 |
Policy instance | 2 |
Insurance contract or identification number | 8100578326 | Number of Individuals Covered | 183 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $17,211 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,184 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 912062 |
Policy instance | 1 |
Insurance contract or identification number | 912062 | Number of Individuals Covered | 281 | Insurance policy start date | 2021-08-01 | Insurance policy end date | 2022-07-31 | Total amount of commissions paid to insurance broker | USD $4,178 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,178 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 912062 |
Policy instance | 1 |
Insurance contract or identification number | 912062 | Number of Individuals Covered | 292 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $4,068 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,068 | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 8100578326 |
Policy instance | 2 |
Insurance contract or identification number | 8100578326 | Number of Individuals Covered | 188 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $12,700 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,700 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 82-2723296 |
Policy instance | 3 |
Insurance contract or identification number | 82-2723296 | Number of Individuals Covered | 156 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $19,256 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,687 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 137075 |
Policy instance | 4 |
Insurance contract or identification number | 137075 | Number of Individuals Covered | 219 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $39,808 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,808 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | P3068 |
Policy instance | 5 |
Insurance contract or identification number | P3068 | Insurance policy start date | 2020-08-01 | Insurance policy end date | 2021-07-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 912062 |
Policy instance | 1 |
Insurance contract or identification number | 912062 | Number of Individuals Covered | 325 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $4,289 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,847 | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 8100578326 |
Policy instance | 2 |
Insurance contract or identification number | 8100578326 | Number of Individuals Covered | 185 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $13,029 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,126 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 82-2723296 |
Policy instance | 3 |
Insurance contract or identification number | 82-2723296 | Number of Individuals Covered | 156 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $19,374 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,687 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 137075 |
Policy instance | 4 |
Insurance contract or identification number | 137075 | Number of Individuals Covered | 238 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $38,457 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,298 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | P3068 |
Policy instance | 5 |
Insurance contract or identification number | P3068 | Number of Individuals Covered | 132 | Insurance policy start date | 2019-08-01 | Insurance policy end date | 2020-07-31 | Total amount of commissions paid to insurance broker | USD $44,819 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,819 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | P3068 |
Policy instance | 5 |
Insurance contract or identification number | P3068 | Number of Individuals Covered | 134 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $79,933 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $79,933 |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 137075 |
Policy instance | 4 |
Insurance contract or identification number | 137075 | Number of Individuals Covered | 246 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $35,517 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,622 | Insurance broker organization code? | 3 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 58-0663085 |
Policy instance | 3 |
Insurance contract or identification number | 58-0663085 | Number of Individuals Covered | 151 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $24,777 | Total amount of fees paid to insurance company | USD $905 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,095 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 667 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 8100578326 |
Policy instance | 2 |
Insurance contract or identification number | 8100578326 | Number of Individuals Covered | 191 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $13,274 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,274 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 912062 |
Policy instance | 1 |
Insurance contract or identification number | 912062 | Number of Individuals Covered | 204 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $3,928 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,553 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 137075 |
Policy instance | 4 |
Insurance contract or identification number | 137075 | Number of Individuals Covered | 186 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Total amount of commissions paid to insurance broker | USD $34,977 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 58-0663085 |
Policy instance | 3 |
Insurance contract or identification number | 58-0663085 | Number of Individuals Covered | 136 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-07-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05938314 |
Policy instance | 2 |
Insurance contract or identification number | TM05938314 | Number of Individuals Covered | 302 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Total amount of commissions paid to insurance broker | USD $4,433 | Total amount of fees paid to insurance company | USD $779 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GUD0ABAR |
Policy instance | 1 |
Insurance contract or identification number | GUD0ABAR | Number of Individuals Covered | 206 | Insurance policy start date | 2017-08-01 | Insurance policy end date | 2018-07-31 | Total amount of commissions paid to insurance broker | USD $4,501 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 126479 |
Policy instance | 1 |
Insurance contract or identification number | 126479 | Number of Individuals Covered | 196 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $44,597 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 44597 | Additional information about fees paid to insurance broker | ACQ/RET | Insurance broker organization code? | 3 | Insurance broker name | JAMES DABNEY COLLIER III |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | W1239 |
Policy instance | 5 |
Insurance contract or identification number | W1239 | Number of Individuals Covered | 47 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $11,786 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,699 | Insurance broker organization code? | 3 | Insurance broker name | CHUCK HUTTON INSURANCE GROUP LLC |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | W1238 |
Policy instance | 4 |
Insurance contract or identification number | W1238 | Number of Individuals Covered | 110 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $34,280 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,589 | Insurance broker organization code? | 3 | Insurance broker name | CHUCK HUTTON ISURANCE GROUP LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 2 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 233 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-10-01 | Total amount of commissions paid to insurance broker | USD $5,729 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,729 | Insurance broker organization code? | 3 | Insurance broker name | JAS. D. COLLIER & CO. |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 126479 |
Policy instance | 1 |
Insurance contract or identification number | 126479 | Number of Individuals Covered | 196 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $38,316 | Total amount of fees paid to insurance company | USD $38,316 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 38316 | Additional information about fees paid to insurance broker | ACQ/RET | Insurance broker organization code? | 3 | Insurance broker name | JAMES DABNEY COLLIER III |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 3 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 234 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-10-01 | Total amount of commissions paid to insurance broker | USD $5,339 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | LONG TERM DISABILITY | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,339 | Insurance broker organization code? | 3 | Insurance broker name | JAS. D. COLLIER & CO. |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 126479 |
Policy instance | 1 |
Insurance contract or identification number | 126479 | Number of Individuals Covered | 177 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $36,492 | Total amount of fees paid to insurance company | USD $36,492 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $588,068 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 36492 | Additional information about fees paid to insurance broker | ACQ/RET | Insurance broker organization code? | 3 | Insurance broker name | JAMES DABNEY COLLIER III |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 3 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 70 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $4,279 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE & AD & D --VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $27,815 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,729 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Insurance broker name | JAS. D. COLLIER & CO. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 2 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 232 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $2,086 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD & D | Welfare Benefit Premiums Paid to Carrier | USD $12,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,086 | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | Insurance broker organization code? | 3 | Insurance broker name | JAS. D. COLLIER & CO. |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 2 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 213 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $1,872 | Total amount of fees paid to insurance company | USD $1,872 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD & D | Welfare Benefit Premiums Paid to Carrier | USD $11,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 126479 |
Policy instance | 1 |
Insurance contract or identification number | 126479 | Number of Individuals Covered | 132 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $26,718 | Total amount of fees paid to insurance company | USD $26,718 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $411,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ABAR |
Policy instance | 3 |
Insurance contract or identification number | G000ABAR | Number of Individuals Covered | 67 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $3,867 | Total amount of fees paid to insurance company | USD $3,867 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE & AD & D --VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $24,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | H68997 |
Policy instance | 2 |
Insurance contract or identification number | H68997 | Number of Individuals Covered | 106 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $22,671 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $479,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29771 |
Policy instance | 4 |
Insurance contract or identification number | 29771 | Number of Individuals Covered | 123 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $983 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TS05328364 |
Policy instance | 3 |
Insurance contract or identification number | TS05328364 | Number of Individuals Covered | 301 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $5,181 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $66,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | AW968 |
Policy instance | 1 |
Insurance contract or identification number | AW968 | Number of Individuals Covered | 62 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $8,930 | Total amount of fees paid to insurance company | USD $201 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | A&S LTD, CANCER, SUPP. HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $59,876 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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