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SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 401k Plan overview

Plan NameSOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN
Plan identification number 502

SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

SOUTHERN MEDICAL HEALTH SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:SOUTHERN MEDICAL HEALTH SYSTEMS, INC.
Employer identification number (EIN):630885975
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2019-07-21
5022017-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2018-07-21
5022016-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2017-07-18
5022015-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2016-10-05
5022014-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2015-10-12
5022013-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2014-10-10
5022012-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2013-10-11
5022011-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2012-10-15
5022009-01-01REBECCA A. CRAWFORD REBECCA A. CRAWFORD2010-10-13

Plan Statistics for SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN

401k plan membership statisitcs for SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN

Measure Date Value
2022: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,596
Total number of active participants reported on line 7a of the Form 55002022-01-011,564
Total of all active and inactive participants2022-01-011,564
Total participants2022-01-011,564
2021: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,939
Total number of active participants reported on line 7a of the Form 55002021-01-011,596
Total of all active and inactive participants2021-01-011,596
Total participants2021-01-011,596
2020: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,955
Total number of active participants reported on line 7a of the Form 55002020-01-011,939
Total of all active and inactive participants2020-01-011,939
Total participants2020-01-011,939
2019: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,872
Total number of active participants reported on line 7a of the Form 55002019-01-011,955
Total of all active and inactive participants2019-01-011,955
Total participants2019-01-011,955
2018: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,797
Total number of active participants reported on line 7a of the Form 55002018-01-011,872
Total of all active and inactive participants2018-01-011,872
Total participants2018-01-011,872
2017: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,818
Total number of active participants reported on line 7a of the Form 55002017-01-011,797
Total of all active and inactive participants2017-01-011,797
Total participants2017-01-011,797
2016: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,890
Total number of active participants reported on line 7a of the Form 55002016-01-011,818
Total of all active and inactive participants2016-01-011,818
Total participants2016-01-011,818
2015: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,787
Total number of active participants reported on line 7a of the Form 55002015-01-011,890
Total of all active and inactive participants2015-01-011,890
Total participants2015-01-011,890
2014: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,683
Total number of active participants reported on line 7a of the Form 55002014-01-011,787
Total of all active and inactive participants2014-01-011,787
Total participants2014-01-011,787
2013: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,343
Total number of active participants reported on line 7a of the Form 55002013-01-011,683
Total of all active and inactive participants2013-01-011,683
Total participants2013-01-011,683
2012: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,276
Total number of active participants reported on line 7a of the Form 55002012-01-011,343
Total of all active and inactive participants2012-01-011,343
Total participants2012-01-011,343
Number of employers contributing to the scheme2012-01-017
2011: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,077
Total number of active participants reported on line 7a of the Form 55002011-01-011,276
Total of all active and inactive participants2011-01-011,276
Total participants2011-01-011,276
2009: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,058
Total number of active participants reported on line 7a of the Form 55002009-01-011,063
Total of all active and inactive participants2009-01-011,063
Total participants2009-01-011,063

Form 5500 Responses for SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN

2022: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: SOUTHERN MEDICAL HEALTH SYSTEMS, INC. LIFE AND AD&D PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number
Policy instance 1
Number of Individuals Covered1564
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $27,237
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
Other welfare benefits providedAD&D
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 $180,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,037
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70601-9
Policy instance 1
Insurance contract or identification number70601-9
Number of Individuals Covered1596
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $33,891
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
Other welfare benefits providedAD&D
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 $190,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,551
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70601-9
Policy instance 1
Insurance contract or identification number70601-9
Number of Individuals Covered1900
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $27,825
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 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
Other welfare benefits providedAD&D
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 $205,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,123
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70601-9
Policy instance 1
Insurance contract or identification number70601-9
Number of Individuals Covered1928
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $34,688
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 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
Other welfare benefits providedAD&D
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 $195,368
Commission paid to Insurance BrokerUSD $8,572
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70601-9
Policy instance 3
Insurance contract or identification number70601-9
Number of Individuals Covered1838
Insurance policy start date2018-06-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $14,223
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $107,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,223
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR672931
Policy instance 2
Insurance contract or identification numberVAR672931
Number of Individuals Covered332
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $175
Total amount of fees paid to insurance companyUSD $182
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $2,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $175
Amount paid for insurance broker fees182
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL668954
Policy instance 1
Insurance contract or identification numberGL668954
Number of Individuals Covered1078
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,529
Total amount of fees paid to insurance companyUSD $7,361
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $93,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,529
Amount paid for insurance broker fees7361
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR672931
Policy instance 2
Insurance contract or identification numberVAR672931
Number of Individuals Covered328
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $375
Total amount of fees paid to insurance companyUSD $269
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $4,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $375
Amount paid for insurance broker fees269
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
Insurance broker nameINSURANCE POINT AGENCY LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL668954
Policy instance 1
Insurance contract or identification numberGL668954
Number of Individuals Covered911
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,462
Total amount of fees paid to insurance companyUSD $9,919
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $180,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,462
Amount paid for insurance broker fees9919
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
Insurance broker nameINSURANCE POINT AGENCY LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668954
Policy instance 1
Insurance contract or identification numberGL 668954
Number of Individuals Covered896
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $15,807
Total amount of fees paid to insurance companyUSD $6,915
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $185,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,807
Amount paid for insurance broker fees6915
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
Insurance broker nameINSURANCE POINT AGENCY
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0390039
Policy instance 2
Insurance contract or identification numberR0390039
Number of Individuals Covered223
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,809
Total amount of fees paid to insurance companyUSD $838
Welfare Benefit Premiums Paid to CarrierUSD $68,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,217
Amount paid for insurance broker fees262
Additional information about fees paid to insurance brokerADMIN AND OTHER FEES
Insurance broker nameENROLLMENT ADVISORS INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 668954
Policy instance 1
Insurance contract or identification numberGL 668954
Number of Individuals Covered1163
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,980
Total amount of fees paid to insurance companyUSD $4,145
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $87,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,980
Amount paid for insurance broker fees4145
Additional information about fees paid to insurance brokerADMIN AND OTHER FEES
Insurance broker nameINSURANCE POINT LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965357
Policy instance 2
Insurance contract or identification numberOK 965357
Number of Individuals Covered1683
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of fees paid to insurance companyUSD $221
Welfare Benefit Premiums Paid to CarrierUSD $12,978
Amount paid for insurance broker fees221
Additional information about fees paid to insurance brokerSALES SERVICE OVERRIDE
Insurance broker organization code?3
Insurance broker nameCOBBS ALLEN & HALL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963722
Policy instance 1
Insurance contract or identification numberFLX963722
Number of Individuals Covered1683
Insurance policy start date2012-10-01
Insurance policy end date2013-10-01
Total amount of fees paid to insurance companyUSD $2,201
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $127,133
Amount paid for insurance broker fees2201
Additional information about fees paid to insurance brokerSALES SERVICE OVERRIDE
Insurance broker nameCOBBS ALLEN & HALL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965357
Policy instance 1
Insurance contract or identification numberOK 965357
Number of Individuals Covered1276
Insurance policy start date2011-10-01
Insurance policy end date2012-10-01
Total amount of fees paid to insurance companyUSD $1,396
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $137,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1269
Additional information about fees paid to insurance brokerOVERRIDE FEES-SUPPL, DEP AND BASIC LIFE
Insurance broker organization code?3
Insurance broker nameCOBBS ALLEN & HALL INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965357
Policy instance 1
Insurance contract or identification numberOK 965357
Number of Individuals Covered1027
Insurance policy start date2010-10-01
Insurance policy end date2011-10-01
Total amount of fees paid to insurance companyUSD $3,036
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $125,812
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberALL00003
Policy instance 1
Insurance contract or identification numberALL00003
Number of Individuals Covered1077
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $7,610
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $190,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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