CUPPLES J & J COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CUPPLES J & J CO., INC. GROUP DISABILITY PLAN
401k plan membership statisitcs for CUPPLES J & J CO., INC. GROUP DISABILITY PLAN
| Measure | Date | Value |
|---|
| 2022: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 492 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 492 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 492 |
| 2021: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 567 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 567 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 567 |
| 2020: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 591 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 591 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
| Total of all active and inactive participants | 2020-07-01 | 591 |
| 2019: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 598 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 598 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
| Total of all active and inactive participants | 2019-07-01 | 598 |
| 2018: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 587 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
| Total of all active and inactive participants | 2018-07-01 | 587 |
| 2017: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 0 |
| 2016: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 418 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 0 |
| 2015: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 393 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 418 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 418 |
| 2014: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 393 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 0 |
| 2013: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 366 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 393 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 393 |
| 2012: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 358 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 366 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 366 |
| 2011: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 358 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 358 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
| Total of all active and inactive participants | 2011-07-01 | 358 |
| 2009: CUPPLES J & J CO., INC. GROUP DISABILITY PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 156 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 156 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 309237 |
| Policy instance | 7 |
| Insurance contract or identification number | 309237 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $34,204 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $227,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $34,204 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05945545 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05945545 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (ADD) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0767731 |
| Policy instance | 2 |
| Insurance contract or identification number | R0767731 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-07-01 | | Total amount of commissions paid to insurance broker | USD $15,165 | | Total amount of fees paid to insurance company | USD $272 | | Welfare Benefit Premiums Paid to Carrier | USD $82,350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,693 | | Amount paid for insurance broker fees | 272 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911946 |
| Policy instance | 3 |
| Insurance contract or identification number | 911946 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911947 |
| Policy instance | 4 |
| Insurance contract or identification number | 911947 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 921638 |
| Policy instance | 5 |
| Insurance contract or identification number | 921638 | | Number of Individuals Covered | 492 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of fees paid to insurance company | USD $70,335 | | Welfare Benefit Premiums Paid to Carrier | USD $2,389,813 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 70335 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 755071 |
| Policy instance | 6 |
| Insurance contract or identification number | 755071 | | Number of Individuals Covered | 492 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of fees paid to insurance company | USD $61,567 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,389,823 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 37612 | | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 309237 |
| Policy instance | 3 |
| Insurance contract or identification number | 309237 | | Number of Individuals Covered | 567 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $33,001 | | Welfare Benefit Premiums Paid to Carrier | USD $265,863 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,001 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 921638 |
| Policy instance | 2 |
| Insurance contract or identification number | 921638 | | Number of Individuals Covered | 526 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $68,941 | | Welfare Benefit Premiums Paid to Carrier | USD $2,304,393 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $68,941 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0767731 |
| Policy instance | 1 |
| Insurance contract or identification number | R0767731 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-07-01 | | Total amount of commissions paid to insurance broker | USD $18,439 | | Welfare Benefit Premiums Paid to Carrier | USD $96,579 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,536 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05945545 |
| Policy instance | 1 |
| Insurance contract or identification number | TM05945545 | | Number of Individuals Covered | 591 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $12,019 | | Total amount of fees paid to insurance company | USD $11 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (ADD) | | Welfare Benefit Premiums Paid to Carrier | USD $120,189 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,019 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 11 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0767731 |
| Policy instance | 2 |
| Insurance contract or identification number | R0767731 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2020-06-30 | | Insurance policy end date | 2021-06-29 | | Total amount of commissions paid to insurance broker | USD $13,060 | | Total amount of fees paid to insurance company | USD $67 | | Welfare Benefit Premiums Paid to Carrier | USD $86,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,482 | | Amount paid for insurance broker fees | 67 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911946 |
| Policy instance | 3 |
| Insurance contract or identification number | 911946 | | Number of Individuals Covered | 278 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $15,541 | | Total amount of fees paid to insurance company | USD $805 | | Welfare Benefit Premiums Paid to Carrier | USD $88,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,541 | | Amount paid for insurance broker fees | 805 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911947 |
| Policy instance | 4 |
| Insurance contract or identification number | 911947 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2020-06-19 | | Insurance policy end date | 2021-06-19 | | Total amount of commissions paid to insurance broker | USD $16,059 | | Total amount of fees paid to insurance company | USD $802 | | Welfare Benefit Premiums Paid to Carrier | USD $97,970 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,059 | | Amount paid for insurance broker fees | 802 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 921638 |
| Policy instance | 5 |
| Insurance contract or identification number | 921638 | | Number of Individuals Covered | 467 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of fees paid to insurance company | USD $61,691 | | Welfare Benefit Premiums Paid to Carrier | USD $1,996,473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 61691 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911946 |
| Policy instance | 6 |
| Insurance contract or identification number | 911946 | | Number of Individuals Covered | 274 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-07-01 | | Total amount of commissions paid to insurance broker | USD $14,697 | | Total amount of fees paid to insurance company | USD $765 | | Welfare Benefit Premiums Paid to Carrier | USD $110,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,697 | | Amount paid for insurance broker fees | 527 | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 240 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $30,410 | | Total amount of fees paid to insurance company | USD $182,983 | | Welfare Benefit Premiums Paid to Carrier | USD $273,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,410 | | Amount paid for insurance broker fees | 110929 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05945545 |
| Policy instance | 2 |
| Insurance contract or identification number | TM05945545 | | Number of Individuals Covered | 598 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $13,096 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (ADD) | | Welfare Benefit Premiums Paid to Carrier | USD $130,882 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,096 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911947 |
| Policy instance | 7 |
| Insurance contract or identification number | 911947 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-07-01 | | Total amount of commissions paid to insurance broker | USD $15,114 | | Total amount of fees paid to insurance company | USD $819 | | Welfare Benefit Premiums Paid to Carrier | USD $117,766 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,114 | | Amount paid for insurance broker fees | 539 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911947 |
| Policy instance | 8 |
| Insurance contract or identification number | 911947 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2019-06-19 | | Insurance policy end date | 2020-06-19 | | Total amount of commissions paid to insurance broker | USD $16,373 | | Total amount of fees paid to insurance company | USD $819 | | Welfare Benefit Premiums Paid to Carrier | USD $109,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,373 | | Amount paid for insurance broker fees | 539 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 21797 |
| Policy instance | 4 |
| Insurance contract or identification number | 21797 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0767731 |
| Policy instance | 5 |
| Insurance contract or identification number | R0767731 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2019-06-30 | | Insurance policy end date | 2020-06-29 | | Total amount of commissions paid to insurance broker | USD $35,902 | | Welfare Benefit Premiums Paid to Carrier | USD $213,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,716 | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $341 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,013 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $137 | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 264 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $31,080 | | Total amount of fees paid to insurance company | USD $192,771 | | Welfare Benefit Premiums Paid to Carrier | USD $279,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,080 | | Amount paid for insurance broker fees | 112127 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 21797 |
| Policy instance | 4 |
| Insurance contract or identification number | 21797 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $205 | | Welfare Benefit Premiums Paid to Carrier | USD $27,699 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $102 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0767731 |
| Policy instance | 5 |
| Insurance contract or identification number | R0767731 | | Number of Individuals Covered | 315 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $23,975 | | Welfare Benefit Premiums Paid to Carrier | USD $52,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,774 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911946 |
| Policy instance | 6 |
| Insurance contract or identification number | 911946 | | Number of Individuals Covered | 299 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $12,344 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,820 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,101 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 911947 |
| Policy instance | 7 |
| Insurance contract or identification number | 911947 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $16,773 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,755 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05945545 |
| Policy instance | 2 |
| Insurance contract or identification number | TM05945545 | | Number of Individuals Covered | 587 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $15,728 | | Total amount of fees paid to insurance company | USD $11,352 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (ADD) | | Welfare Benefit Premiums Paid to Carrier | USD $119,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,652 | | Amount paid for insurance broker fees | 11352 | | Insurance broker organization code? | 3 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 21797 |
| Policy instance | 4 |
| Insurance contract or identification number | 21797 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $3,797 | | Welfare Benefit Premiums Paid to Carrier | USD $55,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,179 | | Insurance broker organization code? | 3 | | Insurance broker name | CODY WHITEHEAD |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 248 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $37,159 | | Total amount of fees paid to insurance company | USD $189,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,159 | | Amount paid for insurance broker fees | 115665 | | Insurance broker organization code? | 3 | | Insurance broker name | PHCS |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $743 | | Life 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 $306 | | Insurance broker organization code? | 3 | | Insurance broker name | MARK HOLLAND |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05945545 |
| Policy instance | 2 |
| Insurance contract or identification number | TM05945545 | | Number of Individuals Covered | 606 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $40,960 | | Total amount of fees paid to insurance company | USD $7,004 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (ADD) | | Welfare Benefit Premiums Paid to Carrier | USD $335,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,960 | | Amount paid for insurance broker fees | 7004 | | Insurance broker organization code? | 3 | | Insurance broker name | |
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| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50022024 |
| Policy instance | 5 |
| Insurance contract or identification number | 50022024 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $27,626 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,813 | | Insurance broker organization code? | 3 | | Insurance broker name | NORTHWESTERN GROUP MARKETING SERVIC |
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| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 21797 |
| Policy instance | 4 |
| Insurance contract or identification number | 21797 | | Number of Individuals Covered | 108 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $32,065 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,709 | | Insurance broker organization code? | 3 | | Insurance broker name | CODY B WHITEHEAD |
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| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1044729 |
| Policy instance | 3 |
| Insurance contract or identification number | 1044729 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $14,862 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 $14,862 | | Insurance broker organization code? | 3 | | Insurance broker name | NFMS OF MEMPHIS LLC |
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| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | XWH1 |
| Policy instance | 2 |
| Insurance contract or identification number | XWH1 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | WHITE & ASSOCIATES INSURANCE AGENCY |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $906 | | Total amount of fees paid to insurance company | USD $21 | | Life 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 $174 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5 | | Insurance broker name | WHITE & ASSOCIATES |
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| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-042154 |
| Policy instance | 6 |
| Insurance contract or identification number | 010-042154 | | Number of Individuals Covered | 418 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $10,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,610 | | Insurance broker organization code? | 3 | | Insurance broker name | NORTHWESTERN GROUP MARKETING SVCS |
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| AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 ) |
| Policy contract number | IOA-542441-15 |
| Policy instance | 7 |
| Insurance contract or identification number | IOA-542441-15 | | Number of Individuals Covered | 225 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $78,253 | | Total amount of fees paid to insurance company | USD $147,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,385 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 124872 | | Insurance broker name | MEDCOM UTILIZATION MANAGEMENT |
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| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1044729 |
| Policy instance | 3 |
| Insurance contract or identification number | 1044729 | | Number of Individuals Covered | 449 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $42,549 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 $42,549 | | Insurance broker organization code? | 3 | | Insurance broker name | WHITE & ASSOCIATES INSURANCE AGENCY |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,821 | | Total amount of fees paid to insurance company | USD $118 | | Life 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 $235 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 69 | | Insurance broker name | WHITE & ASSOCIATES |
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| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | XWH1 |
| Policy instance | 2 |
| Insurance contract or identification number | XWH1 | | Number of Individuals Covered | 390 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of fees paid to insurance company | USD $40,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 40488 | | Insurance broker organization code? | 3 | | Insurance broker name | WHITE & ASSOCIATES INSURANCE AGENCY |
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| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 89211 |
| Policy instance | 2 |
| Insurance contract or identification number | 89211 | | Number of Individuals Covered | 393 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $49,341 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,081 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,341 | | Insurance broker organization code? | 3 | | Insurance broker name | GERALD GOURLEY |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $2,215 | | Total amount of fees paid to insurance company | USD $114 | | Life 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 $197 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 82 | | Insurance broker name | JOSEPH LYNN GREENE |
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| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 89211 |
| Policy instance | 2 |
| Insurance contract or identification number | 89211 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $44,987 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,643 | | Insurance broker organization code? | 3 | | Insurance broker name | GERALD GOURLEY |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $3,012 | | Total amount of fees paid to insurance company | USD $103 | | Life 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 $978 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6 | | Insurance broker name | JOSEPH LYNN GREENE |
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00606749 |
| Policy instance | 3 |
| Insurance contract or identification number | 00606749 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $51,580 | | 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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| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 89211 |
| Policy instance | 2 |
| Insurance contract or identification number | 89211 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $10,263 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 1 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $2,695 | | Total amount of fees paid to insurance company | USD $191 | | Life 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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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7647092 |
| Policy instance | 3 |
| Insurance contract or identification number | E7647092 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $2,649 | | Total amount of fees paid to insurance company | USD $38 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,225 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3 | | Insurance broker name | JOSEPH LYNN GREENE |
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| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
| Policy contract number | 89211 |
| Policy instance | 2 |
| Insurance contract or identification number | 89211 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $43,869 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,807 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,869 | | Additional information about fees paid to insurance broker | ACQRET | | Insurance broker organization code? | 3 | | Insurance broker name | WHITE & ASSOCIATES |
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00384392 |
| Policy instance | 1 |
| Insurance contract or identification number | 00384392 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 | | Insurance broker organization code? | 3 | | Insurance broker name | SEGO, JAMES MICHAEL |
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