FOXWORTH-GALBRAITH LUMBER COMPANY & ASSOCIATED COMPANIES has sponsored the creation of one or more 401k plans.
Additional information about FOXWORTH-GALBRAITH LUMBER COMPANY & ASSOCIATED COMPANIES
Submission information for form 5500 for 401k plan FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN
401k plan membership statisitcs for FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN
Measure | Date | Value |
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2022: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 808 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 806 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 14 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 820 |
2021: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 755 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 796 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 9 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 3 |
Total of all active and inactive participants | 2021-01-01 | 808 |
2020: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 777 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 743 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 12 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 5 |
Total of all active and inactive participants | 2020-01-01 | 760 |
2019: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 377 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 761 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 13 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 774 |
2018: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 357 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 377 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 17 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 394 |
2017: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 546 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 560 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 19 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 579 |
2016: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 496 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 546 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 20 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 566 |
2015: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 461 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 496 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 20 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 516 |
2014: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 402 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 461 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 24 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 485 |
2013: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 370 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 402 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 22 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 424 |
2012: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 350 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 370 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 26 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 396 |
2011: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 364 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 350 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 24 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 374 |
2009: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 894 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 460 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 57 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
Total of all active and inactive participants | 2009-01-01 | 517 |
2022: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2022 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2021 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2020 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2019 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2018 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2017 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2016 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2015 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2014 form 5500 responses |
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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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Mulitple 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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Mulitple 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: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Mulitple employer plan |
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 |
2009: FOXWORTH-GALBRAITH LUMBER COMPANY HEALTH BENEFIT PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Mulitple employer plan |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | LGS02483-21 |
Policy instance | 5 |
Insurance contract or identification number | LGS02483-21 | Number of Individuals Covered | 813 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $45,858 | Other welfare benefits provided | EXCESS LOSS | Welfare Benefit Premiums Paid to Carrier | USD $655,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 45858 | Additional information about fees paid to insurance broker | ADMIN FEE | Insurance broker organization code? | 5 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017888-00 |
Policy instance | 4 |
Insurance contract or identification number | 01-017888-00 | Number of Individuals Covered | 990 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $11,222 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $351,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 11222 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 3 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1462 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $31,274 | Total amount of fees paid to insurance company | USD $6,504 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,274 | Amount paid for insurance broker fees | 6504 | Insurance broker organization code? | 3 |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 2 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1438 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,403 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 1 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 1400 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $42,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 1 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 1160 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $28,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 2 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1500 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $70,513 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 3 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1517 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $28,944 | Total amount of fees paid to insurance company | USD $5,320 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,944 | Amount paid for insurance broker fees | 5320 | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017888-00 |
Policy instance | 4 |
Insurance contract or identification number | 01-017888-00 | Number of Individuals Covered | 1012 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of fees paid to insurance company | USD $6,148 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $313,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6148 | Additional information about fees paid to insurance broker | GROUP VOLUME BONUS | Insurance broker organization code? | 3 |
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QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 ) |
Policy contract number | LGS02483-21 |
Policy instance | 5 |
Insurance contract or identification number | LGS02483-21 | Number of Individuals Covered | 780 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of fees paid to insurance company | USD $43,560 | Other welfare benefits provided | EXCESS LOSS | Welfare Benefit Premiums Paid to Carrier | USD $622,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 43560 | Additional information about fees paid to insurance broker | ADMIN FEE | Insurance broker organization code? | 5 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017888-00 |
Policy instance | 4 |
Insurance contract or identification number | 01-017888-00 | Number of Individuals Covered | 874 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of fees paid to insurance company | USD $9,576 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $323,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 9576 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 3 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1504 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $29,494 | Total amount of fees paid to insurance company | USD $10,850 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,494 | Amount paid for insurance broker fees | 10850 | Insurance broker organization code? | 3 |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 2 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1481 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,829 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 1 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 1160 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $19,100 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 1 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 950 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $19,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 2 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1596 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $71,935 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 3 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1498 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $8,184 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 8184 | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 16-013280-000 |
Policy instance | 4 |
Insurance contract or identification number | 16-013280-000 | Number of Individuals Covered | 760 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $23,722 | Welfare Benefit Premiums Paid to Carrier | USD $454,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 23722 | Additional information about fees paid to insurance broker | GROUP MARKETING SUPPORT | Insurance broker organization code? | 3 |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 01-017888-00 |
Policy instance | 5 |
Insurance contract or identification number | 01-017888-00 | Number of Individuals Covered | 867 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $5,441 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $252,726 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5441 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 1 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 868 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $239,559 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 2 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 800 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $19,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 3 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1822 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,970 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 4 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1452 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,708 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,708 | Insurance broker organization code? | 3 |
|
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 16-013280-000 |
Policy instance | 5 |
Insurance contract or identification number | 16-013280-000 | Number of Individuals Covered | 740 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of fees paid to insurance company | USD $21,836 | Welfare Benefit Premiums Paid to Carrier | USD $413,536 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 21836 | Additional information about fees paid to insurance broker | GROUP MARKETING SUPPORT | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 7 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 54 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,292 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 8 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 76 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,147 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 9 |
Insurance contract or identification number | 07399 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $543 | 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 | 07399 |
Policy instance | 10 |
Insurance contract or identification number | 07399 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114 | 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 | 07399 |
Policy instance | 11 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 123 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 12 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 123 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,858 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 13 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 121 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 16-013280-000 |
Policy instance | 15 |
Insurance contract or identification number | 16-013280-000 | Number of Individuals Covered | 569 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of fees paid to insurance company | USD $13,841 | Welfare Benefit Premiums Paid to Carrier | USD $276,820 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 13841 | Additional information about fees paid to insurance broker | GROUP MARKETING SUPPORT | Insurance broker organization code? | 3 | Insurance broker name | STEALTH BENEFIT SOLUTIONS INC |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 07399 |
Policy instance | 6 |
Insurance contract or identification number | 07399 | Number of Individuals Covered | 54 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,712 | Total amount of fees paid to insurance company | USD $28 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,096 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,712 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 28 | Insurance broker name | AXA ASSISTANCE USA |
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DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) |
Policy contract number | 8200 |
Policy instance | 5 |
Insurance contract or identification number | 8200 | Number of Individuals Covered | 94 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,222 | Total amount of fees paid to insurance company | USD $2,012 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,222 | Amount paid for insurance broker fees | 2012 | Insurance broker organization code? | 3 | Insurance broker name | HUB INTERNATIONAL |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 99310231001 |
Policy instance | 4 |
Insurance contract or identification number | 99310231001 | Number of Individuals Covered | 1344 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,185 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 081509 |
Policy instance | 14 |
Insurance contract or identification number | 081509 | Number of Individuals Covered | 1233 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,873 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,873 | Insurance broker organization code? | 3 | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 156035 |
Policy instance | 1 |
Insurance contract or identification number | 156035 | Number of Individuals Covered | 124 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $26,240 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $527,374 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,240 | Insurance broker organization code? | 3 | Insurance broker name | HUBB INTERNATIONAL MIDWEST LIMITED |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 645 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,225 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $173,952 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,225 | Insurance broker organization code? | 3 | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 3 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 800 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $19,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1136 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $5,832 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5832 | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 489 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,409 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 69 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,236 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MARSH & MCLENNAN AGENY LLC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL18145 |
Policy instance | 4 |
Insurance contract or identification number | HCL18145 | Number of Individuals Covered | 515 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | STOP LOSS | Welfare Benefit Premiums Paid to Carrier | USD $308,271 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 5 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 600 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | OTHER (SPECIFY) EAP | Welfare Benefit Premiums Paid to Carrier | USD $16,302 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MHBT INC |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9934050 |
Policy instance | 6 |
Insurance contract or identification number | 9934050 | Number of Individuals Covered | 4 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9931023 |
Policy instance | 7 |
Insurance contract or identification number | 9931023 | Number of Individuals Covered | 1075 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1126 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 473 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $92,592 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 499 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY INC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL18145 |
Policy instance | 4 |
Insurance contract or identification number | HCL18145 | Number of Individuals Covered | 458 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $271,697 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 5 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 600 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Other welfare benefits provided | OTHER (SPECIFY) EAP | Welfare Benefit Premiums Paid to Carrier | USD $15,048 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | MHBT INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1053 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $6,796 | Total amount of fees paid to insurance company | USD $5,726 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,922 | Amount paid for insurance broker fees | 5726 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 428 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $81,049 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 480 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,147 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 5 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 540 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Other welfare benefits provided | OTHER (SPECIFY) EAP | Welfare Benefit Premiums Paid to Carrier | USD $13,543 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL18145 |
Policy instance | 4 |
Insurance contract or identification number | HCL18145 | Number of Individuals Covered | 410 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,643 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $132,162 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,296 | Insurance broker organization code? | 3 | Insurance broker name | MC & H LIFE AGENCY |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | FXGLO-001 |
Policy instance | 5 |
Insurance contract or identification number | FXGLO-001 | Number of Individuals Covered | 540 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Other welfare benefits provided | OTHER (SPECIFY) EAP | Welfare Benefit Premiums Paid to Carrier | USD $13,543 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL18145 |
Policy instance | 4 |
Insurance contract or identification number | HCL18145 | Number of Individuals Covered | 374 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,312 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $115,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,312 | Insurance broker organization code? | 3 | Insurance broker name | THE PLEXUS GROUPE |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 487 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,785 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 399 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $73,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1005 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $6,641 | Total amount of fees paid to insurance company | USD $5,950 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,641 | Amount paid for insurance broker fees | 5950 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | THE PLEXUS GROUP INC |
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HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL18145 |
Policy instance | 4 |
Insurance contract or identification number | HCL18145 | Number of Individuals Covered | 387 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $2,047 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 525 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1042 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $12,904 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 410 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,645 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 3 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 559 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,079 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 079228 |
Policy instance | 2 |
Insurance contract or identification number | 079228 | Number of Individuals Covered | 397 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,955 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 81509 |
Policy instance | 1 |
Insurance contract or identification number | 81509 | Number of Individuals Covered | 1034 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $16,684 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,008 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,684 | Insurance broker organization code? | 3 | Insurance broker name | THE PLEXUS GROUP INC |
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