401k Plan data: CLECO CORPORATION EMPLOYEE BENEFITS PLAN plan

CLECO CORPORATION EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	CLECO CORPORATION EMPLOYEE BENEFITS PLAN
Plan identification number	507

CLECO CORPORATION EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Severance pay Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

CLECO CORPORATE HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: CLECO CORPORATE HOLDINGS, LLC

Employer identification number (EIN): 721445282

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about CLECO CORPORATE HOLDINGS, LLC

Jurisdiction of Incorporation: Virginia Secretary of State

Incorporation Date: 1980-07-22

Company Identification Number: 0207938

Legal Registered Office Address: DRAWER A
P.O. BOX 1210
ROSEDALE
United States of America (USA)
24280

More information about CLECO CORPORATE HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CLECO CORPORATION EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2023-01-01 KRISTIN GUILLORY 2024-09-11
507 2022-01-01 KRISTIN GUILLORY 2023-10-04
507 2021-01-01 KRISTIN GUILLORY 2022-10-12
507 2020-01-01 KRISTIN GUILLORY 2021-10-11
507 2019-01-01 KAZI HASAN 2020-11-17
507 2018-01-01 KAZI HASAN 2019-10-11
507 2017-01-01
507 2016-01-01
507 2015-01-01
507 2014-01-01
507 2013-01-01
507 2012-01-01 THOMAS R. MILLER
507 2011-01-01 DARREN J OLAGUES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
507	2023-01-01	KRISTIN GUILLORY	2024-09-11
507	2022-01-01	KRISTIN GUILLORY	2023-10-04
507	2021-01-01	KRISTIN GUILLORY	2022-10-12
507	2020-01-01	KRISTIN GUILLORY	2021-10-11
507	2019-01-01	KAZI HASAN	2020-11-17
507	2018-01-01	KAZI HASAN	2019-10-11
507	2017-01-01
507	2016-01-01
507	2015-01-01
507	2014-01-01
507	2013-01-01
507	2012-01-01	THOMAS R. MILLER
507	2011-01-01	DARREN J OLAGUES

Plan Statistics for CLECO CORPORATION EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for CLECO CORPORATION EMPLOYEE BENEFITS PLAN

Measure Date Value
2023: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 2,738
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 2,747
Number of retired or separated participants receiving benefits 2023-01-01 257
Number of other retired or separated participants entitled to future benefits 2023-01-01 289
Total of all active and inactive participants 2023-01-01 3,293
2022: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,883
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 2,738
Number of retired or separated participants receiving benefits 2022-01-01 272
Number of other retired or separated participants entitled to future benefits 2022-01-01 189
Total of all active and inactive participants 2022-01-01 3,199
2021: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,957
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,883
Number of retired or separated participants receiving benefits 2021-01-01 271
Number of other retired or separated participants entitled to future benefits 2021-01-01 170
Total of all active and inactive participants 2021-01-01 2,324
2020: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,894
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,957
Number of retired or separated participants receiving benefits 2020-01-01 202
Number of other retired or separated participants entitled to future benefits 2020-01-01 189
Total of all active and inactive participants 2020-01-01 2,348
2019: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,564
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,479
Number of retired or separated participants receiving benefits 2019-01-01 199
Number of other retired or separated participants entitled to future benefits 2019-01-01 216
Total of all active and inactive participants 2019-01-01 1,894
2018: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,447
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,211
Number of retired or separated participants receiving benefits 2018-01-01 194
Number of other retired or separated participants entitled to future benefits 2018-01-01 159
Total of all active and inactive participants 2018-01-01 1,564
2017: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,792
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,196
Number of retired or separated participants receiving benefits 2017-01-01 194
Number of other retired or separated participants entitled to future benefits 2017-01-01 57
Total of all active and inactive participants 2017-01-01 1,447
2016: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,616
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,207
Number of retired or separated participants receiving benefits 2016-01-01 409
Number of other retired or separated participants entitled to future benefits 2016-01-01 176
Total of all active and inactive participants 2016-01-01 1,792
2015: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,572
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,207
Number of retired or separated participants receiving benefits 2015-01-01 409
Number of other retired or separated participants entitled to future benefits 2015-01-01 131
Total of all active and inactive participants 2015-01-01 1,747
2014: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,572
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,199
Number of retired or separated participants receiving benefits 2014-01-01 383
Number of other retired or separated participants entitled to future benefits 2014-01-01 109
Total of all active and inactive participants 2014-01-01 1,691
2013: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,814
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,200
Number of retired or separated participants receiving benefits 2013-01-01 372
Total of all active and inactive participants 2013-01-01 1,572
2012: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,781
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,257
Number of retired or separated participants receiving benefits 2012-01-01 557
Total of all active and inactive participants 2012-01-01 1,814
2011: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,814
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,233
Number of retired or separated participants receiving benefits 2011-01-01 553
Total of all active and inactive participants 2011-01-01 1,786

Measure	Date	Value
2023: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	2,738
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	2,747
Number of retired or separated participants receiving benefits	2023-01-01	257
Number of other retired or separated participants entitled to future benefits	2023-01-01	289
Total of all active and inactive participants	2023-01-01	3,293
2022: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,883
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	2,738
Number of retired or separated participants receiving benefits	2022-01-01	272
Number of other retired or separated participants entitled to future benefits	2022-01-01	189
Total of all active and inactive participants	2022-01-01	3,199
2021: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,957
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,883
Number of retired or separated participants receiving benefits	2021-01-01	271
Number of other retired or separated participants entitled to future benefits	2021-01-01	170
Total of all active and inactive participants	2021-01-01	2,324
2020: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,894
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,957
Number of retired or separated participants receiving benefits	2020-01-01	202
Number of other retired or separated participants entitled to future benefits	2020-01-01	189
Total of all active and inactive participants	2020-01-01	2,348
2019: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,564
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,479
Number of retired or separated participants receiving benefits	2019-01-01	199
Number of other retired or separated participants entitled to future benefits	2019-01-01	216
Total of all active and inactive participants	2019-01-01	1,894
2018: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,447
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,211
Number of retired or separated participants receiving benefits	2018-01-01	194
Number of other retired or separated participants entitled to future benefits	2018-01-01	159
Total of all active and inactive participants	2018-01-01	1,564
2017: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,792
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,196
Number of retired or separated participants receiving benefits	2017-01-01	194
Number of other retired or separated participants entitled to future benefits	2017-01-01	57
Total of all active and inactive participants	2017-01-01	1,447
2016: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,616
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,207
Number of retired or separated participants receiving benefits	2016-01-01	409
Number of other retired or separated participants entitled to future benefits	2016-01-01	176
Total of all active and inactive participants	2016-01-01	1,792
2015: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,572
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,207
Number of retired or separated participants receiving benefits	2015-01-01	409
Number of other retired or separated participants entitled to future benefits	2015-01-01	131
Total of all active and inactive participants	2015-01-01	1,747
2014: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,572
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,199
Number of retired or separated participants receiving benefits	2014-01-01	383
Number of other retired or separated participants entitled to future benefits	2014-01-01	109
Total of all active and inactive participants	2014-01-01	1,691
2013: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,814
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,200
Number of retired or separated participants receiving benefits	2013-01-01	372
Total of all active and inactive participants	2013-01-01	1,572
2012: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,781
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,257
Number of retired or separated participants receiving benefits	2012-01-01	557
Total of all active and inactive participants	2012-01-01	1,814
2011: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,814
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,233
Number of retired or separated participants receiving benefits	2011-01-01	553
Total of all active and inactive participants	2011-01-01	1,786

Form 5500 Responses for CLECO CORPORATION EMPLOYEE BENEFITS PLAN

2023: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: CLECO CORPORATION EMPLOYEE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

53447

Policy instance

Insurance contract or identification number	53447
Number of Individuals Covered	444
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,333
Total amount of fees paid to insurance company	USD $95
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $6,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )

Policy contract number

LGS02894-23

Policy instance

Insurance contract or identification number	LGS02894-23
Number of Individuals Covered	1259
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $910,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1193
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $53,704
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $290,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1508
Insurance policy start date	2023-01-01
Insurance policy end date	2024-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $719,069
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,959,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	264
Insurance policy start date	2023-01-01
Insurance policy end date	2024-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $40,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	2747
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $267,485
Total amount of fees paid to insurance company	USD $20,053
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,337,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1073
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $61,827
Total amount of fees paid to insurance company	USD $4,625
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $309,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

53447

Policy instance

Insurance contract or identification number	53447
Number of Individuals Covered	444
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,333
Total amount of fees paid to insurance company	USD $87
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $6,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Additional information about fees paid to insurance broker	SALES AND SERVICE COMPENSATION
Insurance broker organization code?	3
Amount paid for insurance broker fees	0

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1427
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $885,600
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,060,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	885600
Additional information about fees paid to insurance broker	ADMINISTRATION SERVICE AND OTHER FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	274
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	2738
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $250,805
Total amount of fees paid to insurance company	USD $21,122
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,254,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $250,805
Amount paid for insurance broker fees	21122
Additional information about fees paid to insurance broker	COMMISSION AND SUPPLEMENTAL COMMISSION
Insurance broker organization code?	3

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL34039

Policy instance

Insurance contract or identification number	HCL34039
Number of Individuals Covered	1226
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $18,686
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $934,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,686
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1180
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $33,202
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $251,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	33202
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1107
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $57,347
Total amount of fees paid to insurance company	USD $4,784
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $286,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $57,347
Amount paid for insurance broker fees	4784
Additional information about fees paid to insurance broker	COMMISSION AND SUPPLEMENTAL COMMISSION
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1500
Insurance policy start date	2021-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $684,167
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,800,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	684167
Additional information about fees paid to insurance broker	ADMINISTRATION SERVICE AND OTHER FEES
Insurance broker organization code?	3

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

53447

Policy instance

Insurance contract or identification number	53447
Number of Individuals Covered	402
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,361
Total amount of fees paid to insurance company	USD $87
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $6,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Additional information about fees paid to insurance broker	SALES AND SERVICE COMPENSATION
Insurance broker organization code?	3
Amount paid for insurance broker fees	87

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1196
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $36,241
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $295,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	36241
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	277
Insurance policy start date	2021-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	1883
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $341,769
Total amount of fees paid to insurance company	USD $26,574
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,580,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $341,769
Amount paid for insurance broker fees	26574
Additional information about fees paid to insurance broker	COMMISSION AND SUPPLEMENTAL COMMISSION
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1159
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $74,786
Total amount of fees paid to insurance company	USD $5,814
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $345,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,786
Amount paid for insurance broker fees	5814
Additional information about fees paid to insurance broker	COMMISSION AND SUPPLEMENTAL COMMISSION
Insurance broker organization code?	3

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL34039

Policy instance

Insurance contract or identification number	HCL34039
Number of Individuals Covered	1221
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $21,446
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,072,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,446
Insurance broker organization code?	3

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

53447

Policy instance

Insurance contract or identification number	53447
Number of Individuals Covered	402
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,226
Total amount of fees paid to insurance company	USD $80
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $6,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Additional information about fees paid to insurance broker	SALES AND SERVICE COMPENSATION
Insurance broker organization code?	3
Amount paid for insurance broker fees	80

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1314
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $37,486
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $283,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	37486
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1568
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,403,176
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,570,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1403176
Additional information about fees paid to insurance broker	ADMINISTRATION SERVICE AND OTHER FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	203
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	1957
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $309,248
Total amount of fees paid to insurance company	USD $17,133
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,553,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $285,105
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Amount paid for insurance broker fees	12857

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1277
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $70,603
Total amount of fees paid to insurance company	USD $3,971
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $354,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $65,179
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Amount paid for insurance broker fees	2958

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL34039

Policy instance

Insurance contract or identification number	HCL34039
Number of Individuals Covered	1369
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $24,699
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,234,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,699
Insurance broker organization code?	3

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1261
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $63,514
Total amount of fees paid to insurance company	USD $1,115
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $317,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $63,514
Amount paid for insurance broker fees	1115
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	1338
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $286,352
Total amount of fees paid to insurance company	USD $5,522
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,431,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $286,352
Amount paid for insurance broker fees	5522
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	193
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1572
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $583,482
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,536,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	583482
Additional information about fees paid to insurance broker	ADMINISTRATION SERVICE AND OTHER FEES
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1327
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $35,577
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $295,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	35577
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	3

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

53447

Policy instance

Insurance contract or identification number	53447
Number of Individuals Covered	402
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,226
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	BUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $6,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,226
Additional information about fees paid to insurance broker	SALES AND SERVICE COMPENSATION
Insurance broker organization code?	3

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL34039

Policy instance

Insurance contract or identification number	HCL34039
Number of Individuals Covered	1367
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $11,692
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,041,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,692
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	416
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,460
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $16,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,460
Insurance broker organization code?	3

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

9473231

Policy instance

Insurance contract or identification number	9473231
Number of Individuals Covered	1115
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $12,595
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $629,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,595
Insurance broker organization code?	4

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1050
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $48,428
Total amount of fees paid to insurance company	USD $6,176
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $223,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,428
Amount paid for insurance broker fees	6176
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	2635
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $239,161
Total amount of fees paid to insurance company	USD $30,485
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,106,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $239,161
Amount paid for insurance broker fees	30485
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	194
Insurance policy start date	2018-01-01
Insurance policy end date	2019-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1303
Insurance policy start date	2018-01-01
Insurance policy end date	2019-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $723,242
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,528,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	723242
Additional information about fees paid to insurance broker	ADMINISTRATION SERVICE AND OTHER FEES
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1083
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $26,462
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $268,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	26462
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1285
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $702,251
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,425,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $702,251
Insurance broker organization code?	3
Insurance broker name	BLUE CROSS AND BLUE SHIELD OF LOUIS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964420

Policy instance

Insurance contract or identification number	FLX964420
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $16,983
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $115,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,983
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )

Policy contract number

MSL 3702996

Policy instance

Insurance contract or identification number	MSL 3702996
Number of Individuals Covered	1102
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $13,423
Welfare Benefit Premiums Paid to Carrier	USD $671,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	13423
Additional information about fees paid to insurance broker	ADMINISTRATIVE SERVICE
Insurance broker organization code?	4
Insurance broker name	AON CONSULTING INC

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	194
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-890-467264

Policy instance

Insurance contract or identification number	SA3-890-467264
Number of Individuals Covered	2589
Insurance policy start date	2017-06-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $107,734
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $628,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $107,734
Insurance broker organization code?	3
Insurance broker name	IMA INC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-890-467264

Policy instance

Insurance contract or identification number	GF3-890-467264
Number of Individuals Covered	1075
Insurance policy start date	2017-06-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $22,039
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,039
Insurance broker organization code?	3
Insurance broker name	IMA INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $3,045
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $30,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,045
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1072
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $26,506
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $268,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,506
Insurance broker organization code?	3
Insurance broker name	VISION SERVICE PLAN

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $30,749
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $311,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,749
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966016

Policy instance

Insurance contract or identification number	OK 966016
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $5,141
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $34,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,141
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-05-31
Total amount of commissions paid to insurance broker	USD $10,172
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $101,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,172
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	429
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $2,486
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $16,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,486
Insurance broker organization code?	3
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964420

Policy instance

Insurance contract or identification number	FLX964420
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $36,300
Total amount of fees paid to insurance company	USD $4,261
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $243,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,300
Amount paid for insurance broker fees	4261
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1280
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $693,264
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,876,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $693,264
Insurance broker organization code?	3
Insurance broker name	BLUE CROSS AND BLUE SHIELD OF LOUIS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	1616
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $8,670
Total amount of fees paid to insurance company	USD $1,248
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $86,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,670
Amount paid for insurance broker fees	1248
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1266
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $30,194
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $309,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,194
Insurance broker name	VISION SERVICE PLAN

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	1616
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $78,918
Total amount of fees paid to insurance company	USD $10,806
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $792,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78,918
Amount paid for insurance broker fees	10806
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966016

Policy instance

Insurance contract or identification number	OK 966016
Number of Individuals Covered	404
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $10,210
Total amount of fees paid to insurance company	USD $968
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $68,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,210
Amount paid for insurance broker fees	968
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	1210
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $25,359
Total amount of fees paid to insurance company	USD $4,415
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $253,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,359
Amount paid for insurance broker fees	4415
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	404
Insurance policy start date	2015-01-01
Insurance policy end date	2016-01-01
Total amount of commissions paid to insurance broker	USD $2,448
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $16,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,448
Additional information about fees paid to insurance broker	ADMINISTRATIVE SERVICES
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF LOUISIANA

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )

Policy contract number

MSL 3702996

Policy instance

Insurance contract or identification number	MSL 3702996
Number of Individuals Covered	1093
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $12,378
Welfare Benefit Premiums Paid to Carrier	USD $618,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	12378
Insurance broker name	AON CONSULTING INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966016

Policy instance

Insurance contract or identification number	OK 966016
Number of Individuals Covered	401
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $8,286
Total amount of fees paid to insurance company	USD $951
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $55,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,286
Amount paid for insurance broker fees	951
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	1582
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $61,624
Total amount of fees paid to insurance company	USD $10,547
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $619,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $61,624
Amount paid for insurance broker fees	10547
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1241
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $518,548
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,802,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	518548
Additional information about fees paid to insurance broker	ADMINISTRATIVE SERVICES OR OTHER FEES
Insurance broker organization code?	3
Insurance broker name	BLUE CROSS AND BLUE SHIELD OF LOUIS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964420

Policy instance

Insurance contract or identification number	FLX964420
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $36,636
Total amount of fees paid to insurance company	USD $4,099
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $245,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,636
Amount paid for insurance broker fees	4099
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	1582
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $7,135
Total amount of fees paid to insurance company	USD $1,410
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $71,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,135
Amount paid for insurance broker fees	1410
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1234
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $29,873
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $299,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,873
Insurance broker name	VISION SERVICE PLAN

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	401
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $2,448
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $16,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,448
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF LOUISIANA

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	1199
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $25,320
Total amount of fees paid to insurance company	USD $4,585
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $253,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,320
Amount paid for insurance broker fees	4585
Additional information about fees paid to insurance broker	SALES & SERVICE
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	1572
Insurance policy start date	2013-08-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $18,925
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $190,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,925
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	1200
Insurance policy start date	2013-08-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $8,673
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,673
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1239
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $32,654
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $332,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,654
Insurance broker organization code?	3
Insurance broker name	VISION SERVICE PLAN

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	1572
Insurance policy start date	2013-01-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $7,880
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $78,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,880
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966016

Policy instance

Insurance contract or identification number	OK 966016
Number of Individuals Covered	390
Insurance policy start date	2013-01-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $7,883
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $52,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,883
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

BLUE CROSS AND BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

78D28ERC

Policy instance

Insurance contract or identification number	78D28ERC
Number of Individuals Covered	1355
Insurance policy start date	2013-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,650,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	390
Insurance policy start date	2013-01-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $2,448
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $16,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,448
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF LOUISIANA

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30029404

Policy instance

Insurance contract or identification number	30029404
Number of Individuals Covered	1443
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $34,446
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $324,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,446
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

PHOENIX EXCESS RISK (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1644
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $147,148
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	REINSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $811,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,148
Insurance broker organization code?	5
Insurance broker name	PHOENIX EXCESS

IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1644
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $29,255
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $78,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,255
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

PPOPLUS (National Association of Insurance Commissioners NAIC id number: 68039 )

Policy contract number

Policy instance

Number of Individuals Covered	1644
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $14,445
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $72,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,445
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1644
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,736
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	U/R
Welfare Benefit Premiums Paid to Carrier	USD $30,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,736
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	1257
Insurance policy start date	2011-08-01
Insurance policy end date	2012-08-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $705,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	557
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $41,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	1257
Insurance policy start date	2011-08-01
Insurance policy end date	2012-08-01
Total amount of commissions paid to insurance broker	USD $26,584
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $265,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,584
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX964420

Policy instance

Insurance contract or identification number	FLX964420
Number of Individuals Covered	1257
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $170,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 966016

Policy instance

Insurance contract or identification number	OK 966016
Number of Individuals Covered	1257
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BEECHSTREET (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1644
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $194
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $194
Insurance broker organization code?	5
Insurance broker name	INSURANCE MANAGEMENT ADMIN.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	411
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Total amount of commissions paid to insurance broker	USD $2,803
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $18,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,803
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF LOUISIANA

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

ABL960182

Policy instance

Insurance contract or identification number	ABL960182
Number of Individuals Covered	385
Insurance policy start date	2011-01-01
Insurance policy end date	2012-01-01
Total amount of commissions paid to insurance broker	USD $2,677
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK961455

Policy instance

Insurance contract or identification number	LK961455
Number of Individuals Covered	1233
Insurance policy start date	2010-08-01
Insurance policy end date	2011-08-01
Total amount of commissions paid to insurance broker	USD $26,237
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $262,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 963500

Policy instance

Insurance contract or identification number	OK 963500
Number of Individuals Covered	553
Insurance policy start date	2011-01-01
Insurance policy end date	2012-01-01
Total amount of commissions paid to insurance broker	USD $2,134
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $21,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX961915

Policy instance

Insurance contract or identification number	FLX961915
Number of Individuals Covered	1233
Insurance policy start date	2010-08-01
Insurance policy end date	2011-08-01
Total amount of commissions paid to insurance broker	USD $74,313
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $751,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BEECHSTREET (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1613
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $214
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

IPROCERT (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1613
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,046
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	U/R
Welfare Benefit Premiums Paid to Carrier	USD $30,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PPOPLUS (National Association of Insurance Commissioners NAIC id number: 68039 )

Policy contract number

Policy instance

Number of Individuals Covered	1613
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $14,443
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $61,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

IHEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

Policy instance

Number of Individuals Covered	1613
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $29,115
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $77,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

Policy instance

Number of Individuals Covered	1613
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $186,329
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	REINSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $1,055,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CLECO CORPORATE HOLDINGS, LLC
Employer identification number (EIN):	721445282
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Virginia Secretary of State
Incorporation Date:	1980-07-22
Company Identification Number:	0207938
Legal Registered Office Address:	DRAWER A P.O. BOX 1210 ROSEDALE United States of America (USA) 24280