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FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 401k Plan overview

Plan NameFEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH
Plan identification number 501

FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:FEDERAL COMPRESS & WAREHOUSE COMPANY, INC.
Employer identification number (EIN):621167633
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01
5012017-01-01VICKIE CORTESE VICKIE CORTESE2018-10-11
5012016-01-01VICKIE CORTESE VICKIE CORTESE2017-10-16
5012015-01-01VICKIE CORTESE VICKIE CORTESE2016-10-13
5012014-01-01VICKIE CORTESE VICKIE CORTESE2015-10-13
5012013-01-01VICKIE CORTESE VICKIE CORTESE2014-10-15
5012012-01-01VICKIE CORTESE VICKIE CORTESE2013-10-14
5012011-01-01VICKIE CORTESE
5012010-01-01VICKIE CORTESE
5012009-01-01VICKIE CORTESE VICKIE CORTESE2010-10-11

Plan Statistics for FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH

401k plan membership statisitcs for FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH

Measure Date Value
2018: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2018 401k membership
Total participants, beginning-of-year2018-01-01110
Total number of active participants reported on line 7a of the Form 55002018-01-0164
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0164
Total participants2018-01-0164
2017: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2017 401k membership
Total participants, beginning-of-year2017-01-01100
Total number of active participants reported on line 7a of the Form 55002017-01-01110
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01110
Total participants2017-01-01110
2016: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2016 401k membership
Total participants, beginning-of-year2016-01-01105
Total number of active participants reported on line 7a of the Form 55002016-01-0199
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0199
Total participants2016-01-0199
2015: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2015 401k membership
Total participants, beginning-of-year2015-01-01112
Total number of active participants reported on line 7a of the Form 55002015-01-01105
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01105
Total participants2015-01-01105
2014: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2014 401k membership
Total participants, beginning-of-year2014-01-01178
Total number of active participants reported on line 7a of the Form 55002014-01-01111
Number of retired or separated participants receiving benefits2014-01-0158
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01169
Total participants2014-01-01169
2013: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2013 401k membership
Total participants, beginning-of-year2013-01-01200
Total number of active participants reported on line 7a of the Form 55002013-01-01115
Number of retired or separated participants receiving benefits2013-01-0163
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01178
2012: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2012 401k membership
Total participants, beginning-of-year2012-01-01211
Total number of active participants reported on line 7a of the Form 55002012-01-01132
Number of retired or separated participants receiving benefits2012-01-0168
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01200
2011: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2011 401k membership
Total participants, beginning-of-year2011-01-01212
Total number of active participants reported on line 7a of the Form 55002011-01-01133
Number of retired or separated participants receiving benefits2011-01-0178
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01211
2010: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2010 401k membership
Total participants, beginning-of-year2010-01-01198
Total number of active participants reported on line 7a of the Form 55002010-01-01129
Number of retired or separated participants receiving benefits2010-01-0183
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01212
2009: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2009 401k membership
Total participants, beginning-of-year2009-01-01219
Total number of active participants reported on line 7a of the Form 55002009-01-01113
Number of retired or separated participants receiving benefits2009-01-0185
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01198

Form 5500 Responses for FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH

2018: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: FEDERAL COMPRESS & WAREHOUSE COMPANY, INC. & AFFILIATES GROUP LIFE & HEALTH 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered61
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $36,907
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,907
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered64
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,980
Total amount of fees paid to insurance companyUSD $138
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,980
Amount paid for insurance broker fees138
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered107
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $38,975
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,975
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered110
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,322
Total amount of fees paid to insurance companyUSD $198
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $27,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,322
Amount paid for insurance broker fees198
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered105
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,580
Total amount of fees paid to insurance companyUSD $164
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $29,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,580
Amount paid for insurance broker fees164
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered101
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $44,234
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,234
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered169
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,947
Total amount of fees paid to insurance companyUSD $162
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $32,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,947
Amount paid for insurance broker fees162
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered111
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $34,167
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,167
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered111
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $45,079
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,080
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered178
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,887
Total amount of fees paid to insurance companyUSD $157
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $32,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,887
Amount paid for insurance broker fees157
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered200
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,775
Total amount of fees paid to insurance companyUSD $146
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,775
Amount paid for insurance broker fees146
Additional information about fees paid to insurance brokerENHANCED COMMISSION COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered129
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $65,189
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,189
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 1
Insurance contract or identification numberGL033184
Number of Individuals Covered211
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,498
Total amount of fees paid to insurance companyUSD $140
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 2
Insurance contract or identification number101001
Number of Individuals Covered125
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $24,724
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL033184
Policy instance 2
Insurance contract or identification numberGL033184
Number of Individuals Covered212
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,346
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number101001
Policy instance 1
Insurance contract or identification number101001
Number of Individuals Covered126
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $38,965
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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