VALUE LINE INC. has sponsored the creation of one or more 401k plans.
Additional information about VALUE LINE INC.
Submission information for form 5500 for 401k plan GROUP LIFE ACCIDENT HOSPITAL SURGICAL MAJOR MEDICAL
401k plan membership statisitcs for GROUP LIFE ACCIDENT HOSPITAL SURGICAL MAJOR MEDICAL
| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 ) |
| Policy contract number | 007837 |
| Policy instance | 5 |
| Insurance contract or identification number | 007837 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-07-31 | | Total amount of commissions paid to insurance broker | USD $3,856 | | Total amount of fees paid to insurance company | USD $1,549 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SUPPLEMENTAL INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $30,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,856 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1549 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 07J6425 |
| Policy instance | 4 |
| Insurance contract or identification number | 07J6425 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $1,122 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,662 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $466 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 3 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-07-31 | | Total amount of commissions paid to insurance broker | USD $66 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0143606 |
| Policy instance | 2 |
| Insurance contract or identification number | 0143606 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2022-03-01 | | Insurance policy end date | 2023-02-28 | | Total amount of commissions paid to insurance broker | USD $66,871 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,164,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,741 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| THE FIRST REHABILITATION LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81434 ) |
| Policy contract number | D561210 |
| Policy instance | 1 |
| Insurance contract or identification number | D561210 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-07-31 | | Total amount of fees paid to insurance company | USD $2,806 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $46,818 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2806 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| THE FIRST REHABILITATION LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81434 ) |
| Policy contract number | D561210 |
| Policy instance | 1 |
| Insurance contract or identification number | D561210 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of fees paid to insurance company | USD $2,265 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $50,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2265 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0143606 |
| Policy instance | 2 |
| Insurance contract or identification number | 0143606 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $74,923 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,323,397 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,605 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 07J6425 |
| Policy instance | 4 |
| Insurance contract or identification number | 07J6425 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2022-02-28 | | Total amount of commissions paid to insurance broker | USD $1,106 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,761 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $476 | | Insurance broker organization code? | 3 |
|
| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 ) |
| Policy contract number | 007837 |
| Policy instance | 5 |
| Insurance contract or identification number | 007837 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $4,140 | | Total amount of fees paid to insurance company | USD $1,713 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SUPPLEMENTAL INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $34,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,140 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1713 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 3 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $90 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,871 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $90 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0143606 |
| Policy instance | 4 |
| Insurance contract or identification number | 0143606 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $65,024 | | Total amount of fees paid to insurance company | USD $3,500 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,284,128 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,290 | | Amount paid for insurance broker fees | 3500 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| THE FIRST REHABILITATION LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81434 ) |
| Policy contract number | D561210 |
| Policy instance | 3 |
| Insurance contract or identification number | D561210 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of fees paid to insurance company | USD $3,004 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $8,973 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3004 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910320 |
| Policy instance | 1 |
| Insurance contract or identification number | 910320 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $666 | | Total amount of fees paid to insurance company | USD $400 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $7,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $666 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 400 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910321 |
| Policy instance | 2 |
| Insurance contract or identification number | 910321 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $313 | | Total amount of fees paid to insurance company | USD $104 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $2,085 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $313 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 104 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 5 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $108 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,092 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $108 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00525463 |
| Policy instance | 6 |
| Insurance contract or identification number | 00525463 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $5,347 | | Total amount of fees paid to insurance company | USD $2,218 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,295 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,347 | | Amount paid for insurance broker fees | 2218 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 07J6425 |
| Policy instance | 7 |
| Insurance contract or identification number | 07J6425 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,404 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $440 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | R0754903 |
| Policy instance | 8 |
| Insurance contract or identification number | R0754903 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $135 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,696 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $135 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 12153148 |
| Policy instance | 9 |
| Insurance contract or identification number | 12153148 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $50 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50 | | Insurance broker organization code? | 3 |
|
| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 ) |
| Policy contract number | 007837 |
| Policy instance | 10 |
| Insurance contract or identification number | 007837 | | Number of Individuals Covered | 151 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $4,131 | | Total amount of fees paid to insurance company | USD $1,784 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SUPPLEMENTAL INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $35,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,131 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1784 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910320 |
| Policy instance | 1 |
| Insurance contract or identification number | 910320 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-05-01 | | Total amount of commissions paid to insurance broker | USD $2,577 | | Total amount of fees paid to insurance company | USD $1,627 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $32,546 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,577 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1627 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910321 |
| Policy instance | 2 |
| Insurance contract or identification number | 910321 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $1,434 | | Total amount of fees paid to insurance company | USD $478 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $9,560 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,434 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 478 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910322 |
| Policy instance | 3 |
| Insurance contract or identification number | 910322 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $1,027 | | Total amount of fees paid to insurance company | USD $342 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $6,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,027 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 342 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $44,102 | | Total amount of fees paid to insurance company | USD $19,600 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,261,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,102 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 19600 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 5 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $292 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,508 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $150 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00525463 |
| Policy instance | 6 |
| Insurance contract or identification number | 00525463 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $4,794 | | Total amount of fees paid to insurance company | USD $2,508 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,924 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,794 | | Amount paid for insurance broker fees | 2508 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 07J6425 |
| Policy instance | 7 |
| Insurance contract or identification number | 07J6425 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $944 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $378 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | R0754903 |
| Policy instance | 8 |
| Insurance contract or identification number | R0754903 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $1,148 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,209 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,148 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 12153148 |
| Policy instance | 9 |
| Insurance contract or identification number | 12153148 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $110 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $110 | | Insurance broker organization code? | 3 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910320 |
| Policy instance | 1 |
| Insurance contract or identification number | 910320 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-05-01 | | Total amount of commissions paid to insurance broker | USD $2,588 | | Total amount of fees paid to insurance company | USD $1,638 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $32,757 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,588 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1638 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910321 |
| Policy instance | 2 |
| Insurance contract or identification number | 910321 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-05-01 | | Total amount of commissions paid to insurance broker | USD $1,469 | | Total amount of fees paid to insurance company | USD $423 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $8,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,469 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 423 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910322 |
| Policy instance | 3 |
| Insurance contract or identification number | 910322 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-05-01 | | Total amount of commissions paid to insurance broker | USD $2,017 | | Total amount of fees paid to insurance company | USD $672 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $13,447 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,017 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 672 |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $49,012 | | Total amount of fees paid to insurance company | USD $21,868 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,399,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,012 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 21868 |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 5 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $421 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,537 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $245 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 0009N810 |
| Policy instance | 6 |
| Insurance contract or identification number | 0009N810 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $5,877 | | Total amount of fees paid to insurance company | USD $1,837 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,652 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,877 | | Amount paid for insurance broker fees | 1837 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 565505 |
| Policy instance | 7 |
| Insurance contract or identification number | 565505 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $1,186 | | Total amount of fees paid to insurance company | USD $177 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $593 | | Amount paid for insurance broker fees | 177 | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 565505 |
| Policy instance | 7 |
| Insurance contract or identification number | 565505 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $1,186 | | Total amount of fees paid to insurance company | USD $177 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 0009N810 |
| Policy instance | 6 |
| Insurance contract or identification number | 0009N810 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $5,877 | | Total amount of fees paid to insurance company | USD $1,837 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,652 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 5 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $533 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $49,012 | | Total amount of fees paid to insurance company | USD $21,868 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,399,953 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910322 |
| Policy instance | 3 |
| Insurance contract or identification number | 910322 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-05-01 | | Total amount of commissions paid to insurance broker | USD $1,114 | | Total amount of fees paid to insurance company | USD $305 | | Other welfare benefits provided | DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $6,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910321 |
| Policy instance | 2 |
| Insurance contract or identification number | 910321 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-05-01 | | Total amount of commissions paid to insurance broker | USD $1,469 | | Total amount of fees paid to insurance company | USD $423 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $8,458 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | 910320 |
| Policy instance | 1 |
| Insurance contract or identification number | 910320 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-05-01 | | Total amount of commissions paid to insurance broker | USD $5,738 | | Total amount of fees paid to insurance company | USD $2,629 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $52,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 5 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $190 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $174 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0905421 |
| Policy instance | 6 |
| Insurance contract or identification number | 0905421 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $1,177 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,800 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,177 | | Insurance broker organization code? | 3 | | Insurance broker name | NESSIM, DANIEL |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 565505 |
| Policy instance | 7 |
| Insurance contract or identification number | 565505 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $1,270 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $635 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2015-04-30 | | Insurance policy end date | 2016-04-29 | | Total amount of commissions paid to insurance broker | USD $1,091 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $33,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,091 | | Insurance broker organization code? | 3 | | Insurance broker name | A&C MANAGEMENT GROUP LTD |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,517 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 104 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $1,592 | | Total amount of fees paid to insurance company | USD $1,459 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,556 | | Amount paid for insurance broker fees | 1459 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | NMP PLANNING CO. INC. |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $49,947 | | Total amount of fees paid to insurance company | USD $23,254 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,414,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 23254 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $49,947 | | Insurance broker name | NESSIM, DANIEL |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 6 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $183 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $183 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH MCLENNAN AGENCY LLC |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 207 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $49,549 | | Total amount of fees paid to insurance company | USD $24,038 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,432,567 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 24038 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $49,549 | | Insurance broker name | NESSIM, DANIEL |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2014-04-30 | | Insurance policy end date | 2015-04-30 | | Total amount of commissions paid to insurance broker | USD $1,107 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $34,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,107 | | Insurance broker organization code? | 3 | | Insurance broker name | A&C MANAGEMENT GROUP LTD |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2013-12-31 | | Insurance policy end date | 2014-12-30 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,824 | | Total amount of fees paid to insurance company | USD $195 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,640 | | Amount paid for insurance broker fees | 195 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | NMP PLANNING CO. INC. |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 565505 |
| Policy instance | 7 |
| Insurance contract or identification number | 565505 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $1,220 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $470 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 573513-SHORT |
| Policy instance | 5 |
| Insurance contract or identification number | 573513-SHORT | | Number of Individuals Covered | 205 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $522 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $247 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $712 | | Total amount of fees paid to insurance company | USD $227 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,898 | | 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 | | Amount paid for insurance broker fees | 227 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | N.M.P. PLANNING CO. INC. |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2012-12-31 | | Insurance policy end date | 2013-12-30 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,109 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $32,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,109 | | Insurance broker organization code? | 3 | | Insurance broker name | A&C MANAGEMENT GROUP LTD |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 573513 |
| Policy instance | 5 |
| Insurance contract or identification number | 573513 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $7,657 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $603 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $37,878 | | Total amount of fees paid to insurance company | USD $23,450 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $907,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,878 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 23450 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 6 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $183 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $183 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH MCLENNAN AGENCY LLC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 565505 |
| Policy instance | 7 |
| Insurance contract or identification number | 565505 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-11-30 | | Total amount of commissions paid to insurance broker | USD $716 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,576 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $358 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 573513 |
| Policy instance | 5 |
| Insurance contract or identification number | 573513 | | Number of Individuals Covered | 186 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-04-30 | | Total amount of commissions paid to insurance broker | USD $6,333 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,342 | | Insurance broker organization code? | 3 | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
| Policy contract number | E7318306 |
| Policy instance | 6 |
| Insurance contract or identification number | E7318306 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $226 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,907 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $226 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH MCLENNAN AGENCY LLC |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $33,773 | | Total amount of fees paid to insurance company | USD $22,526 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $986,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,773 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 22526 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker name | PROFESSIONAL GROUP PLANS INC. |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,064 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $30,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,064 | | Insurance broker organization code? | 3 | | Insurance broker name | NESSIM, DANIEL |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2011-12-31 | | Insurance policy end date | 2012-12-30 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $839 | | Total amount of fees paid to insurance company | USD $287 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $827 | | Amount paid for insurance broker fees | 287 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 3 | | Insurance broker name | N.M.P. PLANNING CO. INC. |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-28 | | Total amount of commissions paid to insurance broker | USD $1,905 | | Total amount of fees paid to insurance company | USD $2,038 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,427 | | 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 | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2010-12-31 | | Insurance policy end date | 2011-12-30 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,047 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $30,491 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 573513 |
| Policy instance | 5 |
| Insurance contract or identification number | 573513 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $4,369 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $47,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | VL2249 |
| Policy instance | 4 |
| Insurance contract or identification number | VL2249 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $24,263 | | Total amount of fees paid to insurance company | USD $16,954 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $741,366 | | 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 | 67035 |
| Policy instance | 2 |
| Insurance contract or identification number | 67035 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2009-12-31 | | Insurance policy end date | 2010-12-31 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,310 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL 026960 |
| Policy instance | 3 |
| Insurance contract or identification number | GL 026960 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,114 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD INSURANCE | | Welfare Benefit Premiums Paid to Carrier | USD $31,662 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | G46 G47 |
| Policy instance | 4 |
| Insurance contract or identification number | G46 G47 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $23,823 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $866,298 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00454273 |
| Policy instance | 1 |
| Insurance contract or identification number | 00454273 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $7,975 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
