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ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 401k Plan overview

Plan NameARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN
Plan identification number 520

ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY 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

ARC OF ACADIANA, INC. has sponsored the creation of one or more 401k plans.

Company Name:ARC OF ACADIANA, INC.
Employer identification number (EIN):720651284
NAIC Classification:621420
NAIC Description:Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5202021-07-01KENNY PATTON2022-10-24 KENNY PATTON2022-10-24
5202020-07-01KENNY PATTON2022-02-14 KENNY PATTON2022-02-14
5202019-07-01KENNY PATTON2021-01-21 KENNY PATTON2021-01-21
5202018-07-01KENNY PATTON2019-09-19 KENNY PATTON2019-09-19
5202017-07-01
5202016-07-01
5202015-07-01
5202014-07-01
5202013-07-01
5202012-12-26JANICE ALLEMAN JANICE ALLEMAN2015-10-07

Plan Statistics for 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
2021: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01277
Total number of active participants reported on line 7a of the Form 55002021-07-01277
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01277
2020: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01283
Total number of active participants reported on line 7a of the Form 55002020-07-01283
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01283
2019: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01215
Total number of active participants reported on line 7a of the Form 55002019-07-01215
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01215
2018: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01205
Total number of active participants reported on line 7a of the Form 55002018-07-01205
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01205
2017: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01225
Total number of active participants reported on line 7a of the Form 55002017-07-01225
Total of all active and inactive participants2017-07-01225
2016: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01234
Total number of active participants reported on line 7a of the Form 55002016-07-01234
Total of all active and inactive participants2016-07-01234
2015: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01334
Total number of active participants reported on line 7a of the Form 55002015-07-01334
Total of all active and inactive participants2015-07-01334
2014: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01343
Total number of active participants reported on line 7a of the Form 55002014-07-01343
Total of all active and inactive participants2014-07-01343
2013: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01348
Total number of active participants reported on line 7a of the Form 55002013-07-01348
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01348
2012: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-12-26210
Total number of active participants reported on line 7a of the Form 55002012-12-26210
Number of retired or separated participants receiving benefits2012-12-260
Number of other retired or separated participants entitled to future benefits2012-12-260
Total of all active and inactive participants2012-12-26210

Form 5500 Responses for ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN

2021: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01First time form 5500 has been submittedYes
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: ARC OF ACADIANA, INC. SECTION 125 PREMIUM ONLY PLAN 2012 form 5500 responses
2012-12-26Type of plan entitySingle employer plan
2012-12-26First time form 5500 has been submittedYes
2012-12-26Submission has been amendedNo
2012-12-26This submission is the final filingNo
2012-12-26This return/report is a short plan year return/report (less than 12 months)Yes
2012-12-26Plan is a collectively bargained planNo
2012-12-26Plan funding arrangement – InsuranceYes
2012-12-26Plan funding arrangement – General assets of the sponsorYes
2012-12-26Plan benefit arrangement – InsuranceYes
2012-12-26Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 3
Insurance contract or identification numberE4272696
Number of Individuals Covered212
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $31,937
Total amount of fees paid to insurance companyUSD $16,624
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $225,589
Commission paid to Insurance BrokerUSD $1,212
Insurance broker organization code?3
Amount paid for insurance broker fees13959
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 2
Insurance contract or identification number78D67ERC
Number of Individuals Covered118
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $27,418
Total amount of fees paid to insurance companyUSD $12,149
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,418
Amount paid for insurance broker fees12149
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered277
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $4,337
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,337
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered283
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $4,266
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,266
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 2
Insurance contract or identification number78D67ERC
Number of Individuals Covered124
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $25,726
Total amount of fees paid to insurance companyUSD $12,075
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,726
Amount paid for insurance broker fees12075
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 3
Insurance contract or identification numberE4272696
Number of Individuals Covered216
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $32,228
Total amount of fees paid to insurance companyUSD $24,674
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $204,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,339
Insurance broker organization code?3
Amount paid for insurance broker fees21813
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 3
Insurance contract or identification numberE4272696
Number of Individuals Covered215
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $25,297
Total amount of fees paid to insurance companyUSD $9,273
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $181,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,686
Insurance broker organization code?3
Amount paid for insurance broker fees7542
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 2
Insurance contract or identification number78D67ERC
Number of Individuals Covered112
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $25,250
Total amount of fees paid to insurance companyUSD $16,297
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,250
Amount paid for insurance broker fees16297
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered126
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $3,826
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,826
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered115
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $3,894
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,112
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 2
Insurance contract or identification numberVPL677514
Number of Individuals Covered131
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $3,227
Total amount of fees paid to insurance companyUSD $144
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $922
Amount paid for insurance broker fees144
Additional information about fees paid to insurance brokerBONUS/INCENTIVE/ADMIN
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 3
Insurance contract or identification number78D67ERC
Number of Individuals Covered142
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $26,859
Total amount of fees paid to insurance companyUSD $18,075
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,859
Amount paid for insurance broker fees18075
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 4
Insurance contract or identification numberE4272696
Number of Individuals Covered205
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $30,371
Total amount of fees paid to insurance companyUSD $4,567
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $190,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,663
Insurance broker organization code?3
Amount paid for insurance broker fees3174
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 4
Insurance contract or identification numberE4272696
Number of Individuals Covered225
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $23,581
Total amount of fees paid to insurance companyUSD $3,944
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $176,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,329
Insurance broker organization code?3
Amount paid for insurance broker fees2816
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker nameREGIONS INSURANCE INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 3
Insurance contract or identification number78D67ERC
Number of Individuals Covered152
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $26,181
Total amount of fees paid to insurance companyUSD $15,457
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,181
Amount paid for insurance broker fees15457
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL GULF SOUTH LTD
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 2
Insurance contract or identification numberVPL677514
Number of Individuals Covered143
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $3,293
Total amount of fees paid to insurance companyUSD $324
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $941
Amount paid for insurance broker fees324
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered122
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $3,645
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,823
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 4
Insurance contract or identification numberE4272696
Number of Individuals Covered289
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $44,371
Total amount of fees paid to insurance companyUSD $5,518
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $205,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $69
Amount paid for insurance broker fees26
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameBKS BENEFITS PLUS LLC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 3
Insurance contract or identification number78D67ERC
Number of Individuals Covered224
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $33,875
Total amount of fees paid to insurance companyUSD $18,568
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 BrokerUSD $12,834
Amount paid for insurance broker fees18568
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL GULF SOUTH LTD
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 2
Insurance contract or identification numberVPL677514
Number of Individuals Covered234
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $4,476
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,279
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-040911
Policy instance 1
Insurance contract or identification number010-040911
Number of Individuals Covered334
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $4,161
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,081
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010040911-00002
Policy instance 1
Insurance contract or identification number010040911-00002
Number of Individuals Covered149
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,461
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $731
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 2
Insurance contract or identification numberVPL677514
Number of Individuals Covered168
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $4,675
Total amount of fees paid to insurance companyUSD $348
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,336
Amount paid for insurance broker fees348
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4272696
Policy instance 4
Insurance contract or identification numberE4272696
Number of Individuals Covered343
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $144,222
Total amount of fees paid to insurance companyUSD $39,241
Other welfare benefits providedCANCER, ACCIDENT, MEDICAL BRIDGE POLICIES
Welfare Benefit Premiums Paid to CarrierUSD $250,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $935
Amount paid for insurance broker fees530
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameTERREL AGENCY INC
BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )
Policy contract number78D67ERC
Policy instance 3
Insurance contract or identification number78D67ERC
Number of Individuals Covered227
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $20,923
Total amount of fees paid to insurance companyUSD $18,568
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $584,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,923
Amount paid for insurance broker fees18568
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameBENEFIT ADVISORY GROUP, LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number0100409-11-0001
Policy instance 5
Insurance contract or identification number0100409-11-0001
Number of Individuals Covered205
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,759
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,379
Insurance broker organization code?3
Insurance broker nameJAMES VAN WALLACE
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPS677715
Policy instance 6
Insurance contract or identification numberVPS677715
Number of Individuals Covered191
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,320
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $320
Insurance broker organization code?3
Insurance broker nameBRADLEY J. GAUTHREAUX
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 1
Insurance contract or identification numberVPL677514
Number of Individuals Covered248
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $4,404
Total amount of fees paid to insurance companyUSD $482
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,258
Amount paid for insurance broker fees482
Additional information about fees paid to insurance brokerBONUS/INCENTIVE
Insurance broker organization code?3
Insurance broker nameBRADLEY J GAUTHREAUX
GUARANTY ASSURANCE COMPANY (GAC) DBA DINA DENTAL (National Association of Insurance Commissioners NAIC id number: 69060 )
Policy contract numberL68205
Policy instance 2
Insurance contract or identification numberL68205
Number of Individuals Covered183
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $9,532
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,681
Insurance broker organization code?3
Insurance broker nameFRANCIS B. CLEMENTS
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberV3858
Policy instance 3
Insurance contract or identification numberV3858
Number of Individuals Covered127
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $26,517
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,517
Insurance broker organization code?3
Insurance broker nameBRADLEY JOSEPH GAUTHREAUX
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number51515
Policy instance 4
Insurance contract or identification number51515
Number of Individuals Covered348
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $91,326
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $131,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,695
Insurance broker organization code?3
Insurance broker nameBRADLEY GAUTHREAUX
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL677514
Policy instance 5
Insurance contract or identification numberVPL677514
Number of Individuals Covered58
Insurance policy start date2012-12-26
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,137
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $325
Insurance broker organization code?3
Insurance broker nameBRADLEY J GAUTHREAUX
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPS677715
Policy instance 4
Insurance contract or identification numberVPS677715
Number of Individuals Covered70
Insurance policy start date2012-12-26
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $5,834
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,414
Insurance broker organization code?3
Insurance broker nameBRADLEY J. GAUTHREAUX
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number51515
Policy instance 3
Insurance contract or identification number51515
Number of Individuals Covered151
Insurance policy start date2012-12-26
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $16,610
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $16,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,305
Insurance broker organization code?3
Insurance broker nameBRADLEY GAUTHREAUX
GUARANTY ASSURANCE COMPANY (GAC) DBA DINA DENTAL (National Association of Insurance Commissioners NAIC id number: 69060 )
Policy contract numberL68205
Policy instance 2
Insurance contract or identification numberL68205
Number of Individuals Covered210
Insurance policy start date2012-12-26
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $2,286
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,554
Insurance broker organization code?3
Insurance broker nameFRANCIS B. CLEMENTS
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberV3858
Policy instance 1
Insurance contract or identification numberV3858
Number of Individuals Covered189
Insurance policy start date2012-12-26
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $12,944
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,944
Insurance broker organization code?3
Insurance broker nameBRADLEY JOSEPH GAUTHREAUX

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