ARC OF ACADIANA, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN
401k plan membership statisitcs for ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN
Measure | Date | Value |
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2021: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-07-01 | 277 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 277 |
Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
Total of all active and inactive participants | 2021-07-01 | 277 |
2020: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-07-01 | 283 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 283 |
Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
Total of all active and inactive participants | 2020-07-01 | 283 |
2019: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-07-01 | 215 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 215 |
Number of retired or separated participants receiving benefits | 2019-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
Total of all active and inactive participants | 2019-07-01 | 215 |
2018: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-07-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 205 |
Number of retired or separated participants receiving benefits | 2018-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
Total of all active and inactive participants | 2018-07-01 | 205 |
2017: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-07-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 225 |
Total of all active and inactive participants | 2017-07-01 | 225 |
2016: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-07-01 | 234 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 234 |
Total of all active and inactive participants | 2016-07-01 | 234 |
2015: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-07-01 | 334 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 334 |
Total of all active and inactive participants | 2015-07-01 | 334 |
2014: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-07-01 | 343 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 343 |
Total of all active and inactive participants | 2014-07-01 | 343 |
2013: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-07-01 | 348 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 348 |
Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
Total of all active and inactive participants | 2013-07-01 | 348 |
2012: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-12-26 | 210 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-12-26 | 210 |
Number of retired or separated participants receiving benefits | 2012-12-26 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-12-26 | 0 |
Total of all active and inactive participants | 2012-12-26 | 210 |
2021: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2021 form 5500 responses |
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2021-07-01 | Type of plan entity | Single employer plan |
2021-07-01 | Submission has been amended | No |
2021-07-01 | This submission is the final filing | No |
2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-07-01 | Plan is a collectively bargained plan | No |
2021-07-01 | Plan funding arrangement – Insurance | Yes |
2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-07-01 | Plan benefit arrangement – Insurance | Yes |
2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2020 form 5500 responses |
---|
2020-07-01 | Type of plan entity | Single employer plan |
2020-07-01 | Submission has been amended | No |
2020-07-01 | This submission is the final filing | No |
2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-07-01 | Plan is a collectively bargained plan | No |
2020-07-01 | Plan funding arrangement – Insurance | Yes |
2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-07-01 | Plan benefit arrangement – Insurance | Yes |
2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2019 form 5500 responses |
---|
2019-07-01 | Type of plan entity | Single employer plan |
2019-07-01 | Submission has been amended | No |
2019-07-01 | This submission is the final filing | No |
2019-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-07-01 | Plan is a collectively bargained plan | No |
2019-07-01 | Plan funding arrangement – Insurance | Yes |
2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-07-01 | Plan benefit arrangement – Insurance | Yes |
2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2018 form 5500 responses |
---|
2018-07-01 | Type of plan entity | Single employer plan |
2018-07-01 | Submission has been amended | No |
2018-07-01 | This submission is the final filing | No |
2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-07-01 | Plan is a collectively bargained plan | No |
2018-07-01 | Plan funding arrangement – Insurance | Yes |
2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-07-01 | Plan benefit arrangement – Insurance | Yes |
2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2017 form 5500 responses |
---|
2017-07-01 | Type of plan entity | Single employer plan |
2017-07-01 | Submission has been amended | No |
2017-07-01 | This submission is the final filing | No |
2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-07-01 | Plan is a collectively bargained plan | No |
2017-07-01 | Plan funding arrangement – Insurance | Yes |
2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-07-01 | Plan benefit arrangement – Insurance | Yes |
2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2016 form 5500 responses |
---|
2016-07-01 | Type of plan entity | Single employer plan |
2016-07-01 | Submission has been amended | No |
2016-07-01 | This submission is the final filing | No |
2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-07-01 | Plan is a collectively bargained plan | No |
2016-07-01 | Plan funding arrangement – Insurance | Yes |
2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-07-01 | Plan benefit arrangement – Insurance | Yes |
2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2015 form 5500 responses |
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2015-07-01 | Type of plan entity | Single employer plan |
2015-07-01 | Submission has been amended | No |
2015-07-01 | This submission is the final filing | No |
2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-07-01 | Plan is a collectively bargained plan | No |
2015-07-01 | Plan funding arrangement – Insurance | Yes |
2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-07-01 | Plan benefit arrangement – Insurance | Yes |
2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2014 form 5500 responses |
---|
2014-07-01 | Type of plan entity | Single employer plan |
2014-07-01 | Submission has been amended | No |
2014-07-01 | This submission is the final filing | No |
2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-07-01 | Plan is a collectively bargained plan | No |
2014-07-01 | Plan funding arrangement – Insurance | Yes |
2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-07-01 | Plan benefit arrangement – Insurance | Yes |
2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2013 form 5500 responses |
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2013-07-01 | Type of plan entity | Single employer plan |
2013-07-01 | First time form 5500 has been submitted | Yes |
2013-07-01 | Submission has been amended | No |
2013-07-01 | This submission is the final filing | No |
2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-07-01 | Plan is a collectively bargained plan | No |
2013-07-01 | Plan funding arrangement – Insurance | Yes |
2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-07-01 | Plan benefit arrangement – Insurance | Yes |
2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2012 form 5500 responses |
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2012-12-26 | Type of plan entity | Single employer plan |
2012-12-26 | First time form 5500 has been submitted | Yes |
2012-12-26 | Submission has been amended | No |
2012-12-26 | This submission is the final filing | No |
2012-12-26 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2012-12-26 | Plan is a collectively bargained plan | No |
2012-12-26 | Plan funding arrangement – Insurance | Yes |
2012-12-26 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-12-26 | Plan benefit arrangement – Insurance | Yes |
2012-12-26 | Plan benefit arrangement – General assets of the sponsor | Yes |
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 3 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 212 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $31,937 | Total amount of fees paid to insurance company | USD $16,624 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $225,589 | Commission paid to Insurance Broker | USD $1,212 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 13959 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 2 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 118 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $27,418 | Total amount of fees paid to insurance company | USD $12,149 | 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 $27,418 | Amount paid for insurance broker fees | 12149 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 277 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $4,337 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,337 | Insurance broker organization code? | 3 |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 283 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $4,266 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,266 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 2 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 124 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $25,726 | Total amount of fees paid to insurance company | USD $12,075 | 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 $25,726 | Amount paid for insurance broker fees | 12075 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 3 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 216 | Insurance policy start date | 2020-07-01 | Insurance policy end date | 2021-06-30 | Total amount of commissions paid to insurance broker | USD $32,228 | Total amount of fees paid to insurance company | USD $24,674 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $204,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,339 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 21813 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 3 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 215 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $25,297 | Total amount of fees paid to insurance company | USD $9,273 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $181,385 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,686 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 7542 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 2 |
Insurance contract or identification number | 78D67ERC | 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 $25,250 | Total amount of fees paid to insurance company | USD $16,297 | 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 $25,250 | Amount paid for insurance broker fees | 16297 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 126 | Insurance policy start date | 2019-07-01 | Insurance policy end date | 2020-06-30 | Total amount of commissions paid to insurance broker | USD $3,826 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65,350 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,826 | Insurance broker organization code? | 3 |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 115 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $3,894 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,628 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,112 | Insurance broker organization code? | 3 |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 2 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 131 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $3,227 | Total amount of fees paid to insurance company | USD $144 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $922 | Amount paid for insurance broker fees | 144 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE/ADMIN | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 3 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 142 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $26,859 | Total amount of fees paid to insurance company | USD $18,075 | 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 $26,859 | Amount paid for insurance broker fees | 18075 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 4 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 205 | Insurance policy start date | 2018-07-01 | Insurance policy end date | 2019-06-30 | Total amount of commissions paid to insurance broker | USD $30,371 | Total amount of fees paid to insurance company | USD $4,567 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $190,368 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,663 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 3174 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 4 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 225 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $23,581 | Total amount of fees paid to insurance company | USD $3,944 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $176,839 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,329 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2816 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker name | REGIONS INSURANCE INC |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 3 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 152 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $26,181 | Total amount of fees paid to insurance company | USD $15,457 | 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 $26,181 | Amount paid for insurance broker fees | 15457 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL GULF SOUTH LTD |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 2 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 143 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $3,293 | Total amount of fees paid to insurance company | USD $324 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,410 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $941 | Amount paid for insurance broker fees | 324 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 122 | Insurance policy start date | 2017-07-01 | Insurance policy end date | 2018-06-30 | Total amount of commissions paid to insurance broker | USD $3,645 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,446 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,823 | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
|
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 4 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 289 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $44,371 | Total amount of fees paid to insurance company | USD $5,518 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $205,628 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69 | Amount paid for insurance broker fees | 26 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | BKS BENEFITS PLUS LLC |
|
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 3 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 224 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $33,875 | Total amount of fees paid to insurance company | USD $18,568 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,026,752 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,834 | Amount paid for insurance broker fees | 18568 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL GULF SOUTH LTD |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 2 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 234 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $4,476 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,792 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,279 | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040911 |
Policy instance | 1 |
Insurance contract or identification number | 010-040911 | Number of Individuals Covered | 334 | Insurance policy start date | 2015-07-01 | Insurance policy end date | 2016-06-30 | Total amount of commissions paid to insurance broker | USD $4,161 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,709 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,081 | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010040911-00002 |
Policy instance | 1 |
Insurance contract or identification number | 010040911-00002 | Number of Individuals Covered | 149 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,461 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,610 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $731 | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 2 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 168 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $4,675 | Total amount of fees paid to insurance company | USD $348 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,360 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,336 | Amount paid for insurance broker fees | 348 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4272696 |
Policy instance | 4 |
Insurance contract or identification number | E4272696 | Number of Individuals Covered | 343 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $144,222 | Total amount of fees paid to insurance company | USD $39,241 | Other welfare benefits provided | CANCER, ACCIDENT, MEDICAL BRIDGE POLICIES | Welfare Benefit Premiums Paid to Carrier | USD $250,980 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $935 | Amount paid for insurance broker fees | 530 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | TERREL AGENCY INC |
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BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) |
Policy contract number | 78D67ERC |
Policy instance | 3 |
Insurance contract or identification number | 78D67ERC | Number of Individuals Covered | 227 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $20,923 | Total amount of fees paid to insurance company | USD $18,568 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $584,769 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,923 | Amount paid for insurance broker fees | 18568 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | BENEFIT ADVISORY GROUP, LLC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 0100409-11-0001 |
Policy instance | 5 |
Insurance contract or identification number | 0100409-11-0001 | Number of Individuals Covered | 205 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $2,759 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $65,098 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,379 | Insurance broker organization code? | 3 | Insurance broker name | JAMES VAN WALLACE |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPS677715 |
Policy instance | 6 |
Insurance contract or identification number | VPS677715 | Number of Individuals Covered | 191 | Insurance policy start date | 2014-07-01 | Insurance policy end date | 2015-06-30 | Total amount of commissions paid to insurance broker | USD $1,320 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $320 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY J. GAUTHREAUX |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 1 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 248 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $4,404 | Total amount of fees paid to insurance company | USD $482 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,258 | Amount paid for insurance broker fees | 482 | Additional information about fees paid to insurance broker | BONUS/INCENTIVE | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY J GAUTHREAUX |
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GUARANTY ASSURANCE COMPANY (GAC) DBA DINA DENTAL (National Association of Insurance Commissioners NAIC id number: 69060 ) |
Policy contract number | L68205 |
Policy instance | 2 |
Insurance contract or identification number | L68205 | Number of Individuals Covered | 183 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $9,532 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $77,478 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,681 | Insurance broker organization code? | 3 | Insurance broker name | FRANCIS B. CLEMENTS |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | V3858 |
Policy instance | 3 |
Insurance contract or identification number | V3858 | Number of Individuals Covered | 127 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $26,517 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,517 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY JOSEPH GAUTHREAUX |
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BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
Policy contract number | 51515 |
Policy instance | 4 |
Insurance contract or identification number | 51515 | Number of Individuals Covered | 348 | Insurance policy start date | 2013-07-01 | Insurance policy end date | 2014-06-30 | Total amount of commissions paid to insurance broker | USD $91,326 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $131,293 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,695 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY GAUTHREAUX |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPL677514 |
Policy instance | 5 |
Insurance contract or identification number | VPL677514 | Number of Individuals Covered | 58 | Insurance policy start date | 2012-12-26 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $1,137 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,249 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $325 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY J GAUTHREAUX |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VPS677715 |
Policy instance | 4 |
Insurance contract or identification number | VPS677715 | Number of Individuals Covered | 70 | Insurance policy start date | 2012-12-26 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $5,834 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,680 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,414 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY J. GAUTHREAUX |
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BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
Policy contract number | 51515 |
Policy instance | 3 |
Insurance contract or identification number | 51515 | Number of Individuals Covered | 151 | Insurance policy start date | 2012-12-26 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $16,610 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,311 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,305 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY GAUTHREAUX |
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GUARANTY ASSURANCE COMPANY (GAC) DBA DINA DENTAL (National Association of Insurance Commissioners NAIC id number: 69060 ) |
Policy contract number | L68205 |
Policy instance | 2 |
Insurance contract or identification number | L68205 | Number of Individuals Covered | 210 | Insurance policy start date | 2012-12-26 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $2,286 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,039 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,554 | Insurance broker organization code? | 3 | Insurance broker name | FRANCIS B. CLEMENTS |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | V3858 |
Policy instance | 1 |
Insurance contract or identification number | V3858 | Number of Individuals Covered | 189 | Insurance policy start date | 2012-12-26 | Insurance policy end date | 2013-06-30 | Total amount of commissions paid to insurance broker | USD $12,944 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,944 | Insurance broker organization code? | 3 | Insurance broker name | BRADLEY JOSEPH GAUTHREAUX |
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