LOCAL GOVERNMENT CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LOCAL GOVERNMENT CORPORATION FLEXIBLE BENEFIT PLAN
401k plan membership statisitcs for LOCAL GOVERNMENT CORPORATION FLEXIBLE BENEFIT PLAN
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 26 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $447 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $8,639 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $447 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | LBT |
Policy instance | 4 |
Insurance contract or identification number | LBT | Number of Individuals Covered | 21 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $762 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $11,193 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $418 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | 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 | 531037 |
Policy instance | 3 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 152 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-12-01 | Total amount of commissions paid to insurance broker | USD $4,834 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $32,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,834 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 2 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 68 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $2,520 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,520 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | 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 | 00626857 |
Policy instance | 1 |
Insurance contract or identification number | 00626857 | Number of Individuals Covered | 249 | Insurance policy start date | 2021-09-01 | Insurance policy end date | 2022-08-31 | Total amount of commissions paid to insurance broker | USD $15,110 | Total amount of fees paid to insurance company | USD $123,080 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,202,454 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,110 | Amount paid for insurance broker fees | 123080 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BD7D |
Policy instance | 6 |
Insurance contract or identification number | G000BD7D | Number of Individuals Covered | 149 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-11-01 | Total amount of commissions paid to insurance broker | USD $20,159 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $134,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,159 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 26 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $852 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $8,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $852 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | LBT |
Policy instance | 4 |
Insurance contract or identification number | LBT | Number of Individuals Covered | 21 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $766 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $10,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $422 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BD7D |
Policy instance | 6 |
Insurance contract or identification number | G000BD7D | Number of Individuals Covered | 148 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-11-01 | Total amount of commissions paid to insurance broker | USD $18,582 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $123,888 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,582 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 2 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 67 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $2,798 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,798 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00626857 |
Policy instance | 1 |
Insurance contract or identification number | 00626857 | Number of Individuals Covered | 243 | Insurance policy start date | 2020-09-01 | Insurance policy end date | 2021-08-31 | Total amount of commissions paid to insurance broker | USD $13,426 | Total amount of fees paid to insurance company | USD $116,618 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,094,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,426 | Amount paid for insurance broker fees | 116618 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | 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 | 531037 |
Policy instance | 3 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 151 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-12-01 | Total amount of commissions paid to insurance broker | USD $4,682 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $31,273 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,682 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES & COMMISSIONS | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | LBT |
Policy instance | 4 |
Insurance contract or identification number | LBT | Number of Individuals Covered | 22 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $790 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $10,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $437 | 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 | 00626857 |
Policy instance | 1 |
Insurance contract or identification number | 00626857 | Number of Individuals Covered | 247 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $21,328 | Total amount of fees paid to insurance company | USD $116,921 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,085,179 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,328 | Amount paid for insurance broker fees | 116921 | Additional information about fees paid to insurance broker | BENEFIT ADVISOR FEES | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BD7D |
Policy instance | 6 |
Insurance contract or identification number | G000BD7D | Number of Individuals Covered | 143 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2020-11-01 | Total amount of commissions paid to insurance broker | USD $11,624 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $77,489 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,624 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 25 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $436 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $7,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $436 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 2 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 69 | Insurance policy start date | 2019-09-01 | Insurance policy end date | 2020-08-31 | Total amount of commissions paid to insurance broker | USD $2,356 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $23,937 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,356 | 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 | 531037 |
Policy instance | 3 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 157 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-12-01 | Total amount of commissions paid to insurance broker | USD $4,712 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $31,415 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,712 | 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 | 531037 |
Policy instance | 3 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 149 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-12-01 | Total amount of commissions paid to insurance broker | USD $4,627 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $30,344 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,627 | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | LBT |
Policy instance | 4 |
Insurance contract or identification number | LBT | Number of Individuals Covered | 22 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $864 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $12,032 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $477 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10227698 |
Policy instance | 5 |
Insurance contract or identification number | 10227698 | Number of Individuals Covered | 145 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $5,857 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,285 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,857 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10227697 |
Policy instance | 6 |
Insurance contract or identification number | 10227697 | Number of Individuals Covered | 145 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $4,929 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $24,646 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,929 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 7 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 18 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $2,060 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $6,869 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,060 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 2 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 66 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $2,778 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,527 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,778 | 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 | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 371 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $131,955 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,345,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $131,955 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10227697 |
Policy instance | 6 |
Insurance contract or identification number | 10227697 | Number of Individuals Covered | 144 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $5,786 | Total amount of fees paid to insurance company | USD $856 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 7 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 18 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $450 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,279 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10227698 |
Policy instance | 5 |
Insurance contract or identification number | 10227698 | Number of Individuals Covered | 144 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $4,667 | Total amount of fees paid to insurance company | USD $649 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,333 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 2 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 69 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $2,378 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,227 | 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 | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 361 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $116,617 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,191,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 3 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 126 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-12-01 | Total amount of commissions paid to insurance broker | USD $4,211 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $28,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | LBT |
Policy instance | 4 |
Insurance contract or identification number | LBT | Number of Individuals Covered | 22 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,076 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $17,087 | 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 | GVTL0259G |
Policy instance | 7 |
Insurance contract or identification number | GVTL0259G | Number of Individuals Covered | 75 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $3,177 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,180 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,177 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 6 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 110 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-12-01 | Total amount of commissions paid to insurance broker | USD $2,559 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $17,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,559 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 69 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-30 | Total amount of commissions paid to insurance broker | USD $2,597 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,763 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,597 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00417680 |
Policy instance | 4 |
Insurance contract or identification number | 00417680 | Number of Individuals Covered | 110 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $1,804 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,804 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0259G |
Policy instance | 2 |
Insurance contract or identification number | GLUG0259G | Number of Individuals Covered | 126 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $2,403 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,020 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,403 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 335 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $90,939 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,719,890 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $90,939 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0259G |
Policy instance | 3 |
Insurance contract or identification number | GLTD0259G | Number of Individuals Covered | 126 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-09-01 | Total amount of commissions paid to insurance broker | USD $2,731 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,208 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,731 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0259G |
Policy instance | 2 |
Insurance contract or identification number | GLUG0259G | Number of Individuals Covered | 123 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $2,101 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $14,006 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,101 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 333 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $84,767 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,613,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $84,767 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0259G |
Policy instance | 7 |
Insurance contract or identification number | GVTL0259G | Number of Individuals Covered | 75 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $3,073 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,487 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,073 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 6 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 115 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $2,197 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $14,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,197 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 67 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $2,625 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $25,494 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,625 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00417680 |
Policy instance | 4 |
Insurance contract or identification number | 00417680 | Number of Individuals Covered | 109 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $1,771 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,771 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0259G |
Policy instance | 3 |
Insurance contract or identification number | GLTD0259G | Number of Individuals Covered | 123 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-09-01 | Total amount of commissions paid to insurance broker | USD $2,366 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,773 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,366 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0259G |
Policy instance | 2 |
Insurance contract or identification number | GLUG0259G | Number of Individuals Covered | 127 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-09-01 | Total amount of commissions paid to insurance broker | USD $2,110 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $14,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,110 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES, INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00417680 |
Policy instance | 7 |
Insurance contract or identification number | 00417680 | Number of Individuals Covered | 113 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $1,724 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,724 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 6 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 119 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $2,306 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $14,269 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,306 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES INC |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | G8630 |
Policy instance | 5 |
Insurance contract or identification number | G8630 | Number of Individuals Covered | 10 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $581 | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $4,938 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $255 | Insurance broker organization code? | 3 | Insurance broker name | DANIEL M SPEER |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 4 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 69 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $2,670 | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $26,335 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,670 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0259G |
Policy instance | 3 |
Insurance contract or identification number | GLTD0259G | Number of Individuals Covered | 127 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-09-01 | Total amount of commissions paid to insurance broker | USD $2,298 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,320 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,298 | Insurance broker organization code? | 3 | Insurance broker name | ROGER WITHEROW & ASSOCIATES INC |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 341 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $71,044 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,436,760 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $71,044 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM ROGER WITHEROW |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00417680 |
Policy instance | 7 |
Insurance contract or identification number | 00417680 | Number of Individuals Covered | 111 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $1,717 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,558 |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | G8630 |
Policy instance | 5 |
Insurance contract or identification number | G8630 | Number of Individuals Covered | 11 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $702 | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $5,234 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 4 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 71 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $2,343 | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $25,987 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0259G |
Policy instance | 3 |
Insurance contract or identification number | GLTD0259G | Number of Individuals Covered | 123 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $2,780 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,181 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0259G |
Policy instance | 2 |
Insurance contract or identification number | GLUG0259G | Number of Individuals Covered | 123 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $2,697 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $13,665 |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 332 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $50,033 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,394,692 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 6 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 116 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-10-01 | Total amount of commissions paid to insurance broker | USD $2,093 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $13,953 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00417680 |
Policy instance | 7 |
Insurance contract or identification number | 00417680 | Number of Individuals Covered | 119 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $4,051 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,486 | 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 | G8630 |
Policy instance | 6 |
Insurance contract or identification number | G8630 | Number of Individuals Covered | 11 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $702 | Other welfare benefits provided | CANCER INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $5,234 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 531037 |
Policy instance | 4 |
Insurance contract or identification number | 531037 | Number of Individuals Covered | 121 | Insurance policy start date | 2009-12-01 | Insurance policy end date | 2010-12-01 | Total amount of commissions paid to insurance broker | USD $2,042 | Other welfare benefits provided | GROUP LONG TERM CARE INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $13,584 | 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 | GLTD0259G |
Policy instance | 3 |
Insurance contract or identification number | GLTD0259G | Number of Individuals Covered | 119 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-09-01 | Total amount of commissions paid to insurance broker | USD $2,335 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,685 | 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 | GLUG0259G |
Policy instance | 2 |
Insurance contract or identification number | GLUG0259G | Number of Individuals Covered | 121 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-09-01 | Total amount of commissions paid to insurance broker | USD $2,337 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD | Welfare Benefit Premiums Paid to Carrier | USD $13,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 05221 |
Policy instance | 5 |
Insurance contract or identification number | 05221 | Number of Individuals Covered | 70 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $2,400 | Other welfare benefits provided | CANCER | Welfare Benefit Premiums Paid to Carrier | USD $26,710 | 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 | 93707 |
Policy instance | 1 |
Insurance contract or identification number | 93707 | Number of Individuals Covered | 334 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $51,373 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,295,362 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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