CROWN BAKERIES LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CROWN BAKERIES LLC FRINGE BENEFIT PLAN
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10194811001 |
Policy instance | 2 |
Insurance contract or identification number | 10194811001 | Number of Individuals Covered | 901 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,936 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,410 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,936 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 7341 |
Policy instance | 1 |
Insurance contract or identification number | 7341 | Number of Individuals Covered | 956 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $35,933 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $35,933 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 943098 |
Policy instance | 3 |
Insurance contract or identification number | 943098 | Number of Individuals Covered | 1031 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $35,920 | Total amount of fees paid to insurance company | USD $14,932 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS, VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $654,747 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,920 | Amount paid for insurance broker fees | 14932 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 943098 |
Policy instance | 3 |
Insurance contract or identification number | 943098 | Number of Individuals Covered | 669 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $29,603 | Total amount of fees paid to insurance company | USD $14,249 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL AND AA CRITIAL ILLNESS, STD, VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $401,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,865 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS AMOUNT |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10194811001 |
Policy instance | 2 |
Insurance contract or identification number | 10194811001 | Number of Individuals Covered | 567 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,523 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $286 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 7341 |
Policy instance | 1 |
Insurance contract or identification number | 7341 | Number of Individuals Covered | 886 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $23,416 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $23,416 | Amount paid for insurance broker fees | 0 | 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 | 35864 |
Policy instance | 2 |
Insurance contract or identification number | 35864 | Number of Individuals Covered | 187 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $9,197 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT AND CRITICAL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $47,765 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,340 | 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 | 95046 |
Policy instance | 1 |
Insurance contract or identification number | 95046 | Number of Individuals Covered | 115 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $8,000 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $56,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $4,000 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 7341 |
Policy instance | 3 |
Insurance contract or identification number | 7341 | Number of Individuals Covered | 606 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $16,735 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,935 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10194811001 |
Policy instance | 4 |
Insurance contract or identification number | 10194811001 | Number of Individuals Covered | 475 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,031 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,471 | Amount paid for insurance broker fees | 0 | 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 | 473394 |
Policy instance | 5 |
Insurance contract or identification number | 473394 | Number of Individuals Covered | 650 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $8,500 | Total amount of fees paid to insurance company | USD $2,400 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $8,500 | Amount paid for insurance broker fees | 2400 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | 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 | 95046 |
Policy instance | 1 |
Insurance contract or identification number | 95046 | Number of Individuals Covered | 112 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $8,315 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $55,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,157 | Amount paid for insurance broker fees | 0 | 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 | 35864 |
Policy instance | 2 |
Insurance contract or identification number | 35864 | Number of Individuals Covered | 139 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $24,580 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT AND CRITICAL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $60,167 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,633 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 7304251 |
Policy instance | 3 |
Insurance contract or identification number | 7304251 | Number of Individuals Covered | 6 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $76 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | CRITICAL ILLINESS; ISWL STND | Welfare Benefit Premiums Paid to Carrier | USD $1,655 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 7341 |
Policy instance | 4 |
Insurance contract or identification number | 7341 | Number of Individuals Covered | 521 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $15,908 | Total amount of fees paid to insurance company | USD $0 | Dental 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 $15,908 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10194811001 |
Policy instance | 5 |
Insurance contract or identification number | 10194811001 | Number of Individuals Covered | 411 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,399 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,111 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,399 | Amount paid for insurance broker fees | 0 | 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 | 473394 |
Policy instance | 6 |
Insurance contract or identification number | 473394 | Number of Individuals Covered | 643 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $8,384 | Total amount of fees paid to insurance company | USD $2,345 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $156,125 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,384 | Amount paid for insurance broker fees | 2345 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 10194811001 |
Policy instance | 3 |
Insurance contract or identification number | 10194811001 | Number of Individuals Covered | 436 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,234 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 7304251 |
Policy instance | 2 |
Insurance contract or identification number | 7304251 | Number of Individuals Covered | 7 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $104 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | CRITICAL ILLINESS; ISWL STND | Welfare Benefit Premiums Paid to Carrier | USD $1,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52 | Amount paid for insurance broker fees | 0 | 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 | 403005383 |
Policy instance | 1 |
Insurance contract or identification number | 403005383 | Number of Individuals Covered | 65 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $834 | Total amount of fees paid to insurance company | USD $22 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | SPOUSE AND VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $5,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $834 | Amount paid for insurance broker fees | 22 | Additional information about fees paid to insurance broker | BROKER BONUS | 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 | 000010209781 |
Policy instance | 6 |
Insurance contract or identification number | 000010209781 | Number of Individuals Covered | 434 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,231 | Total amount of fees paid to insurance company | USD $69 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $21,539 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,231 | Amount paid for insurance broker fees | 69 | Additional information about fees paid to insurance broker | BROKER BONUS | 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 | 000010209782 |
Policy instance | 4 |
Insurance contract or identification number | 000010209782 | Number of Individuals Covered | 434 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $4,371 | Total amount of fees paid to insurance company | USD $96 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,139 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,371 | Amount paid for insurance broker fees | 96 | Additional information about fees paid to insurance broker | BROKER BONUS | 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 | 000010209783 |
Policy instance | 5 |
Insurance contract or identification number | 000010209783 | Number of Individuals Covered | 434 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $11,441 | Total amount of fees paid to insurance company | USD $243 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $76,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,441 | Amount paid for insurance broker fees | 243 | Additional information about fees paid to insurance broker | BROKER BONUS | 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 | 0001D035420 |
Policy instance | 7 |
Insurance contract or identification number | 0001D035420 | Number of Individuals Covered | 284 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $13,925 | Total amount of fees paid to insurance company | USD $15,960 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $126,595 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,925 | Amount paid for insurance broker fees | 15960 | Additional information about fees paid to insurance broker | CONSULTING FEES AND BROKER BONUS | 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 | 400001000020370 |
Policy instance | 8 |
Insurance contract or identification number | 400001000020370 | Number of Individuals Covered | 97 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $5,638 | Total amount of fees paid to insurance company | USD $122 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,586 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,638 | Amount paid for insurance broker fees | 122 | Additional information about fees paid to insurance broker | BROKER BONUS | 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 | 000400234100 |
Policy instance | 9 |
Insurance contract or identification number | 000400234100 | Number of Individuals Covered | 225 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,690 | Total amount of fees paid to insurance company | USD $2,047 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,897 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,690 | Amount paid for insurance broker fees | 2047 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 1 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 257 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,745 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,207 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 6601 |
Policy instance | 9 |
Insurance contract or identification number | 6601 | Number of Individuals Covered | 582 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $14,838 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,098 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 906302 |
Policy instance | 8 |
Insurance contract or identification number | 906302 | Number of Individuals Covered | 553 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $77,692 | Total amount of fees paid to insurance company | USD $5,000 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $77,692 | Amount paid for insurance broker fees | 5000 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040023410 |
Policy instance | 7 |
Insurance contract or identification number | 00040023410 | Number of Individuals Covered | 246 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $568 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $568 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 400001000020370 |
Policy instance | 6 |
Insurance contract or identification number | 400001000020370 | Number of Individuals Covered | 118 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $7,309 | Total amount of fees paid to insurance company | USD $0 | 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 $5,051 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 906302 |
Policy instance | 2 |
Insurance contract or identification number | 906302 | Number of Individuals Covered | 553 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $77,692 | Total amount of fees paid to insurance company | USD $5,000 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $77,692 | Amount paid for insurance broker fees | 5000 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209783 |
Policy instance | 4 |
Insurance contract or identification number | 000010209783 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $14,574 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,786 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 ) |
Policy contract number | 6601 |
Policy instance | 3 |
Insurance contract or identification number | 6601 | Number of Individuals Covered | 582 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $14,838 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,098 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209782 |
Policy instance | 5 |
Insurance contract or identification number | 000010209782 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $5,786 | 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 $3,984 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 400001000020370 |
Policy instance | 7 |
Insurance contract or identification number | 400001000020370 | Number of Individuals Covered | 118 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $7,309 | 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 $5,051 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 0001D035420 |
Policy instance | 8 |
Insurance contract or identification number | 0001D035420 | Number of Individuals Covered | 320 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,938 | Total amount of fees paid to insurance company | USD $1,336 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,938 | Amount paid for insurance broker fees | 1336 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400234100 |
Policy instance | 9 |
Insurance contract or identification number | 000400234100 | Number of Individuals Covered | 246 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $568 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $568 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 0001D035420 |
Policy instance | 5 |
Insurance contract or identification number | 0001D035420 | Number of Individuals Covered | 320 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,938 | Total amount of fees paid to insurance company | USD $1,336 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,938 | Amount paid for insurance broker fees | 1336 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209781 |
Policy instance | 4 |
Insurance contract or identification number | 000010209781 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,142 | Total amount of fees paid to insurance company | USD $0 | 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 $2,785 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 3 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 257 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,745 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,207 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209783 |
Policy instance | 2 |
Insurance contract or identification number | 000010209783 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $14,574 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,786 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209782 |
Policy instance | 1 |
Insurance contract or identification number | 000010209782 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $5,786 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,984 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER COMPANY |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010209781 |
Policy instance | 6 |
Insurance contract or identification number | 000010209781 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,142 | 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 $2,785 | Insurance broker organization code? | 3 | Insurance broker name | JAMES D. COLLIER & COMPANY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 1 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 738 | Total amount of commissions paid to insurance broker | USD $11,293 | Total amount of fees paid to insurance company | USD $1,654 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,429 | Amount paid for insurance broker fees | 1654 | Insurance broker organization code? | 3 | Insurance broker name | NFP INSURANCE SERVICES INC. |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 2 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 244 | Total amount of commissions paid to insurance broker | USD $2,599 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,599 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 3 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 64 | Total amount of commissions paid to insurance broker | USD $3,154 | 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 $2,050 | Amount paid for insurance broker fees | 103 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | RITTENBERG, INC. |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 607208 |
Policy instance | 4 |
Insurance contract or identification number | 607208 | Number of Individuals Covered | 304 | Total amount of commissions paid to insurance broker | USD $75,795 | Total amount of fees paid to insurance company | USD $1,726 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $75,795 | Amount paid for insurance broker fees | 1726 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 7304251 |
Policy instance | 6 |
Insurance contract or identification number | 7304251 | Number of Individuals Covered | 27 | Total amount of commissions paid to insurance broker | USD $382 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $191 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 234310 |
Policy instance | 5 |
Insurance contract or identification number | 234310 | Number of Individuals Covered | 494 | Total amount of commissions paid to insurance broker | USD $29,658 | Total amount of fees paid to insurance company | USD $868 | 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 $29,539 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 868 | Additional information about fees paid to insurance broker | BONUSES & ADDITIONAL PAYMENTS | Insurance broker name | ROBERT LEVY |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 1 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 500 | Total amount of commissions paid to insurance broker | USD $13,017 | Total amount of fees paid to insurance company | USD $28 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,104 | Amount paid for insurance broker fees | 28 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | NFP INSURANCE SERVICES INC. |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 2 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 145 | Total amount of commissions paid to insurance broker | USD $2,132 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,132 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 3 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 64 | Total amount of commissions paid to insurance broker | USD $3,154 | 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 $2,050 | Insurance broker name | RITTENBERG, INC. |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 607208 |
Policy instance | 4 |
Insurance contract or identification number | 607208 | Number of Individuals Covered | 192 | Total amount of commissions paid to insurance broker | USD $52,271 | Total amount of fees paid to insurance company | USD $11,813 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $52,271 | Amount paid for insurance broker fees | 11813 | Additional information about fees paid to insurance broker | DIRECT COMPENSATION | Insurance broker organization code? | 4 | Insurance broker name | PARADIGM GROUP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 234310 |
Policy instance | 5 |
Insurance contract or identification number | 234310 | Number of Individuals Covered | 238 | Total amount of commissions paid to insurance broker | USD $12,500 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,500 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 7304251 |
Policy instance | 6 |
Insurance contract or identification number | 7304251 | Number of Individuals Covered | 32 | Total amount of commissions paid to insurance broker | USD $532 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $266 | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT COMMUNICATIONS INC |
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KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
Policy contract number | 603093 |
Policy instance | 3 |
Insurance contract or identification number | 603093 | Number of Individuals Covered | 266 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 4 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 66 | Total amount of commissions paid to insurance broker | USD $2,528 | Total amount of fees paid to insurance company | USD $82 | 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 $1,643 | Amount paid for insurance broker fees | 82 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | RITTENBERG, INC. |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 607208 |
Policy instance | 5 |
Insurance contract or identification number | 607208 | Number of Individuals Covered | 187 | 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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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 2 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 141 | Total amount of commissions paid to insurance broker | USD $14,298 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,216 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 1 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 368 | Total amount of commissions paid to insurance broker | USD $9,713 | Total amount of fees paid to insurance company | USD $851 | Dental 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 $9,713 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 851 | Insurance broker name | NFP INSURANCE SERVICES INC. |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 5 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 319 | Total amount of commissions paid to insurance broker | USD $9,795 | Dental 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 $817 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 4 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 123 | Total amount of commissions paid to insurance broker | USD $2,205 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,205 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 ) |
Policy contract number | 603093 |
Policy instance | 3 |
Insurance contract or identification number | 603093 | Number of Individuals Covered | 210 | Total amount of commissions paid to insurance broker | USD $10,592 | 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 $4,760 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | EDWARD RITTENBERG |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 607208 |
Policy instance | 1 |
Insurance contract or identification number | 607208 | Number of Individuals Covered | 237 | Total amount of commissions paid to insurance broker | USD $41,135 | Total amount of fees paid to insurance company | USD $21,613 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,135 | Amount paid for insurance broker fees | 21613 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICE FEES | Insurance broker name | PARADIGM GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 2 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 54 | Total amount of commissions paid to insurance broker | USD $3,042 | Total amount of fees paid to insurance company | USD $99 | 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 $1,065 | Amount paid for insurance broker fees | 99 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 112913 |
Policy instance | 7 |
Insurance contract or identification number | 112913 | Total amount of commissions paid to insurance broker | USD $66,927 | 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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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 6 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 350 | Total amount of commissions paid to insurance broker | USD $8,687 | Dental 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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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 5 |
Insurance contract or identification number | VS1155 | Number of Individuals Covered | 138 | Total amount of commissions paid to insurance broker | USD $2,010 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065332 |
Policy instance | 4 |
Insurance contract or identification number | 000010065332 | Total amount of commissions paid to insurance broker | USD $2,220 | Total amount of fees paid to insurance company | USD $568 | 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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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065334 |
Policy instance | 2 |
Insurance contract or identification number | 000010065334 | Number of Individuals Covered | 209 | Total amount of commissions paid to insurance broker | USD $4,362 | Total amount of fees paid to insurance company | USD $888 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065333 |
Policy instance | 3 |
Insurance contract or identification number | 000010065333 | Number of Individuals Covered | 209 | Total amount of commissions paid to insurance broker | USD $6,563 | Total amount of fees paid to insurance company | USD $1,546 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 1 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 52 | Total amount of commissions paid to insurance broker | USD $2,248 | Total amount of fees paid to insurance company | USD $122 | 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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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 112913 |
Policy instance | 7 |
Insurance contract or identification number | 112913 | Number of Individuals Covered | 369 | Total amount of commissions paid to insurance broker | USD $57,755 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57,755 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05599193 |
Policy instance | 6 |
Insurance contract or identification number | TM05599193 | Number of Individuals Covered | 355 | Total amount of commissions paid to insurance broker | USD $331 | Dental 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 $331 | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | VS1155 |
Policy instance | 5 |
Insurance contract or identification number | VS1155 | Total amount of commissions paid to insurance broker | USD $1,913 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,913 | Insurance broker name | PARADIGM GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065332 |
Policy instance | 4 |
Insurance contract or identification number | 000010065332 | Number of Individuals Covered | 213 | Total amount of commissions paid to insurance broker | USD $1,886 | Total amount of fees paid to insurance company | USD $592 | 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 $1,886 | Amount paid for insurance broker fees | 592 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065333 |
Policy instance | 3 |
Insurance contract or identification number | 000010065333 | Number of Individuals Covered | 208 | Total amount of commissions paid to insurance broker | USD $5,134 | Total amount of fees paid to insurance company | USD $1,237 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,134 | Amount paid for insurance broker fees | 1237 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 572824 |
Policy instance | 1 |
Insurance contract or identification number | 572824 | Number of Individuals Covered | 63 | Total amount of commissions paid to insurance broker | USD $776 | Total amount of fees paid to insurance company | USD $42 | 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 $272 | Amount paid for insurance broker fees | 42 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010065334 |
Policy instance | 2 |
Insurance contract or identification number | 000010065334 | Number of Individuals Covered | 208 | Total amount of commissions paid to insurance broker | USD $2,955 | Total amount of fees paid to insurance company | USD $804 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,955 | Amount paid for insurance broker fees | 804 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | PARADIGM GROUP |
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