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A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 401k Plan overview

Plan NameA-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN
Plan identification number 501

A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

A-1 CONTRACT STAFFING GROUP LLC has sponsored the creation of one or more 401k plans.

Company Name:A-1 CONTRACT STAFFING GROUP LLC
Employer identification number (EIN):650920215
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01CINDY FOWLER2022-07-27
5012020-01-01CINDY FOWLER2021-08-17
5012019-01-01CINDY FOWLER2020-10-09
5012018-01-01CINDY FOWLER2019-10-09
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01THOMAS D. HARRINGTON, JR VP
5012011-01-01THOMAS D. HARRINGTON, JR VP
5012010-01-01THOMAS D. HARRINGTON, JR
5012009-01-01THOMAS D. HARRINGTON, JR

Plan Statistics for A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN

401k plan membership statisitcs for A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN

Measure Date Value
2021: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0123,842
Total number of active participants reported on line 7a of the Form 55002021-01-011,773
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,773
2020: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0115,926
Total number of active participants reported on line 7a of the Form 55002020-01-011,928
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,928
2019: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0120,095
Total number of active participants reported on line 7a of the Form 55002019-01-013,424
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-013,424
2018: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-013,759
Total number of active participants reported on line 7a of the Form 55002018-01-012,409
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,409
2017: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012,357
Total number of active participants reported on line 7a of the Form 55002017-01-013,759
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-013,759
2016: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,006
Total number of active participants reported on line 7a of the Form 55002016-01-012,357
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012,357
2015: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,897
Total number of active participants reported on line 7a of the Form 55002015-01-012,006
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-012,006
2014: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-018,750
Total number of active participants reported on line 7a of the Form 55002014-01-011,897
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,897
2013: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,193
Total number of active participants reported on line 7a of the Form 55002013-01-018,750
Total of all active and inactive participants2013-01-018,750
2012: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01707
Total number of active participants reported on line 7a of the Form 55002012-01-012,193
Total of all active and inactive participants2012-01-012,193
2011: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01891
Total number of active participants reported on line 7a of the Form 55002011-01-01707
Total of all active and inactive participants2011-01-01707
2010: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,615
Total number of active participants reported on line 7a of the Form 55002010-01-01891
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01891
2009: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,931
Total number of active participants reported on line 7a of the Form 55002009-01-011,615
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,615

Form 5500 Responses for A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN

2021: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entityMulti-employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: A-1 CONTRACT STAFFING GROUP LLC BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered724
Insurance policy start date2022-01-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $6,305
Total amount of fees paid to insurance companyUSD $20,051
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $398,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,305
Amount paid for insurance broker fees20051
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered306
Insurance policy start date2022-01-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $29,886
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 BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $281,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,886
Amount paid for insurance broker fees0
Insurance broker organization code?3
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number573867
Policy instance 4
Insurance contract or identification number573867
Number of Individuals Covered4
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $1,517
Total amount of fees paid to insurance companyUSD $36
Welfare Benefit Premiums Paid to CarrierUSD $75,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $789
Insurance broker organization code?3
Amount paid for insurance broker fees36
Additional information about fees paid to insurance brokerBONUS
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number573867
Policy instance 3
Insurance contract or identification number573867
Number of Individuals Covered103
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $26,011
Total amount of fees paid to insurance companyUSD $1,047
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $1,075,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,526
Insurance broker organization code?3
Amount paid for insurance broker fees1047
Additional information about fees paid to insurance brokerBONUS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered1207
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,062
Total amount of fees paid to insurance companyUSD $23,653
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $820,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,062
Amount paid for insurance broker fees23653
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered377
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $45,673
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $439,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,673
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered1797
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,987
Total amount of fees paid to insurance companyUSD $20,049
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $990,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,987
Amount paid for insurance broker fees20049
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number573867
Policy instance 3
Insurance contract or identification number573867
Number of Individuals Covered308
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $65,380
Total amount of fees paid to insurance companyUSD $319
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $2,671,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,997
Insurance broker organization code?3
Amount paid for insurance broker fees319
Additional information about fees paid to insurance brokerBONUS
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number573867
Policy instance 4
Insurance contract or identification number573867
Number of Individuals Covered6
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $2,081
Total amount of fees paid to insurance companyUSD $16
Welfare Benefit Premiums Paid to CarrierUSD $103,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,082
Insurance broker organization code?3
Amount paid for insurance broker fees16
Additional information about fees paid to insurance brokerBONUS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered502
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $54,681
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $523,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,681
Insurance broker organization code?3
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number573867
Policy instance 4
Insurance contract or identification number573867
Number of Individuals Covered14
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $3,300
Total amount of fees paid to insurance companyUSD $60
Welfare Benefit Premiums Paid to CarrierUSD $131,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,716
Insurance broker organization code?3
Amount paid for insurance broker fees60
Additional information about fees paid to insurance brokerBONUS
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number573867
Policy instance 3
Insurance contract or identification number573867
Number of Individuals Covered306
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $62,787
Total amount of fees paid to insurance companyUSD $2,914
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $2,520,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,649
Insurance broker organization code?3
Amount paid for insurance broker fees2914
Additional information about fees paid to insurance brokerBONUS
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered621
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $58,611
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $556,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,611
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered2237
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $25,529
Total amount of fees paid to insurance companyUSD $25,259
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,309,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,529
Amount paid for insurance broker fees25259
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract number573867
Policy instance 5
Insurance contract or identification number573867
Number of Individuals Covered0
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $317
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $6,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $288
Insurance broker organization code?3
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number573867
Policy instance 4
Insurance contract or identification number573867
Number of Individuals Covered15
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $6,258
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $240,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,146
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number573867
Policy instance 3
Insurance contract or identification number573867
Number of Individuals Covered395
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $73,733
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $2,796,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,302
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered2426
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $26,523
Total amount of fees paid to insurance companyUSD $24,678
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,434,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,523
Amount paid for insurance broker fees24678
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered650
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $57,667
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $543,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,667
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00429790
Policy instance 2
Insurance contract or identification number00429790
Number of Individuals Covered2409
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,675
Total amount of fees paid to insurance companyUSD $24,101
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,357,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,675
Amount paid for insurance broker fees24101
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameUNITED BENEFIT ADVISORS OF FLO
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number573867
Policy instance 3
Insurance contract or identification number573867
Number of Individuals Covered436
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $96,428
Total amount of fees paid to insurance companyUSD $2,078
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $3,146,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,285
Insurance broker organization code?3
Amount paid for insurance broker fees2078
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameDIGITAL INSURANCE INC-GA
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. (National Association of Insurance Commissioners NAIC id number: 69671 )
Policy contract number573867
Policy instance 4
Insurance contract or identification number573867
Number of Individuals Covered18
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $4,123
Total amount of fees paid to insurance companyUSD $43
Welfare Benefit Premiums Paid to CarrierUSD $126,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,144
Insurance broker organization code?3
Amount paid for insurance broker fees43
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameDIGITAL INSURANCE INC-GA
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract number573867
Policy instance 5
Insurance contract or identification number573867
Number of Individuals Covered22
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $855
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSUPPLEMENTAL CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $10,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $582
Insurance broker organization code?3
Insurance broker nameA-1 BENEFIT CONSULTANTS INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number573867
Policy instance 6
Insurance contract or identification number573867
Number of Individuals Covered29
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $9,190
Total amount of fees paid to insurance companyUSD $260
Welfare Benefit Premiums Paid to CarrierUSD $366,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,779
Insurance broker organization code?3
Amount paid for insurance broker fees260
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameDIGITAL INSURANCE INC-GA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number76309
Policy instance 1
Insurance contract or identification number76309
Number of Individuals Covered646
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $66,165
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $609,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,165
Insurance broker organization code?3
Insurance broker nameGORDON E. HANNAWAY

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