BLISS COMMUNICATIONS, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC
401k plan membership statisitcs for GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC
Measure | Date | Value |
---|
2019: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-04-01 | 186 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 0 |
Total of all active and inactive participants | 2019-04-01 | 0 |
2018: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-04-01 | 229 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 185 |
Number of retired or separated participants receiving benefits | 2018-04-01 | 1 |
Total of all active and inactive participants | 2018-04-01 | 186 |
2017: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-04-01 | 194 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 188 |
Number of retired or separated participants receiving benefits | 2017-04-01 | 3 |
Total of all active and inactive participants | 2017-04-01 | 191 |
2016: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-04-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 190 |
Total of all active and inactive participants | 2016-04-01 | 190 |
2015: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-04-01 | 230 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 225 |
Number of retired or separated participants receiving benefits | 2015-04-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-04-01 | 0 |
Total of all active and inactive participants | 2015-04-01 | 225 |
2014: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-04-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 230 |
Number of retired or separated participants receiving benefits | 2014-04-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-04-01 | 0 |
Total of all active and inactive participants | 2014-04-01 | 230 |
2013: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-04-01 | 264 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 262 |
Number of retired or separated participants receiving benefits | 2013-04-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-04-01 | 0 |
Total of all active and inactive participants | 2013-04-01 | 262 |
2012: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-04-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 264 |
Number of retired or separated participants receiving benefits | 2012-04-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-04-01 | 0 |
Total of all active and inactive participants | 2012-04-01 | 264 |
2011: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-04-01 | 288 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 262 |
Number of retired or separated participants receiving benefits | 2011-04-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-04-01 | 0 |
Total of all active and inactive participants | 2011-04-01 | 262 |
Total participants | 2011-04-01 | 262 |
2009: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-04-01 | 341 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 290 |
Number of retired or separated participants receiving benefits | 2009-04-01 | 11 |
Number of other retired or separated participants entitled to future benefits | 2009-04-01 | 1 |
Total of all active and inactive participants | 2009-04-01 | 302 |
2019: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2019 form 5500 responses |
---|
2019-04-01 | Type of plan entity | Single employer plan |
2019-04-01 | Submission has been amended | No |
2019-04-01 | This submission is the final filing | Yes |
2019-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2019-04-01 | Plan is a collectively bargained plan | No |
2019-04-01 | Plan funding arrangement – Insurance | Yes |
2019-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-04-01 | Plan benefit arrangement – Insurance | Yes |
2019-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2018 form 5500 responses |
---|
2018-04-01 | Type of plan entity | Single employer plan |
2018-04-01 | Submission has been amended | No |
2018-04-01 | This submission is the final filing | No |
2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-04-01 | Plan is a collectively bargained plan | No |
2018-04-01 | Plan funding arrangement – Insurance | Yes |
2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-04-01 | Plan benefit arrangement – Insurance | Yes |
2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2017 form 5500 responses |
---|
2017-04-01 | Type of plan entity | Single employer plan |
2017-04-01 | Submission has been amended | No |
2017-04-01 | This submission is the final filing | No |
2017-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-04-01 | Plan is a collectively bargained plan | No |
2017-04-01 | Plan funding arrangement – Insurance | Yes |
2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-04-01 | Plan benefit arrangement – Insurance | Yes |
2017-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2016 form 5500 responses |
---|
2016-04-01 | Type of plan entity | Single employer plan |
2016-04-01 | Submission has been amended | No |
2016-04-01 | This submission is the final filing | No |
2016-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-04-01 | Plan is a collectively bargained plan | No |
2016-04-01 | Plan funding arrangement – Insurance | Yes |
2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-04-01 | Plan benefit arrangement – Insurance | Yes |
2016-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2015 form 5500 responses |
---|
2015-04-01 | Type of plan entity | Single employer plan |
2015-04-01 | Submission has been amended | No |
2015-04-01 | This submission is the final filing | No |
2015-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-04-01 | Plan is a collectively bargained plan | No |
2015-04-01 | Plan funding arrangement – Insurance | Yes |
2015-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-04-01 | Plan benefit arrangement – Insurance | Yes |
2015-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2014 form 5500 responses |
---|
2014-04-01 | Type of plan entity | Single employer plan |
2014-04-01 | Submission has been amended | No |
2014-04-01 | This submission is the final filing | No |
2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-04-01 | Plan is a collectively bargained plan | No |
2014-04-01 | Plan funding arrangement – Insurance | Yes |
2014-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-04-01 | Plan benefit arrangement – Insurance | Yes |
2014-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2013 form 5500 responses |
---|
2013-04-01 | Type of plan entity | Single employer plan |
2013-04-01 | Submission has been amended | No |
2013-04-01 | This submission is the final filing | No |
2013-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-04-01 | Plan is a collectively bargained plan | No |
2013-04-01 | Plan funding arrangement – Insurance | Yes |
2013-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-04-01 | Plan benefit arrangement – Insurance | Yes |
2013-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2012 form 5500 responses |
---|
2012-04-01 | Type of plan entity | Single employer plan |
2012-04-01 | Submission has been amended | No |
2012-04-01 | This submission is the final filing | No |
2012-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-04-01 | Plan is a collectively bargained plan | No |
2012-04-01 | Plan funding arrangement – Insurance | Yes |
2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-04-01 | Plan benefit arrangement – Insurance | Yes |
2012-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2011 form 5500 responses |
---|
2011-04-01 | Type of plan entity | Single employer plan |
2011-04-01 | Submission has been amended | No |
2011-04-01 | This submission is the final filing | No |
2011-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-04-01 | Plan is a collectively bargained plan | No |
2011-04-01 | Plan funding arrangement – Insurance | Yes |
2011-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-04-01 | Plan benefit arrangement – Insurance | Yes |
2011-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: GROUP LIFE, AD&D AND MEDICAL PLAN FOR EMPLOYEES OF BLISS COMMUNICATIONS, INC 2009 form 5500 responses |
---|
2009-04-01 | Type of plan entity | Single employer plan |
2009-04-01 | Submission has been amended | No |
2009-04-01 | This submission is the final filing | No |
2009-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-04-01 | Plan is a collectively bargained plan | No |
2009-04-01 | Plan funding arrangement – Insurance | Yes |
2009-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-04-01 | Plan benefit arrangement – Insurance | Yes |
2009-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 4 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $1,090 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $5,615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,090 | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM5943652 |
Policy instance | 1 |
Insurance contract or identification number | KM5943652 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $3,713 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $22,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,713 | Insurance broker organization code? | 3 |
|
WYSSTA INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
Policy contract number | 41837 |
Policy instance | 2 |
Insurance contract or identification number | 41837 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $179 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,240 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $179 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 3 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2019-07-31 | Total amount of commissions paid to insurance broker | USD $1,205 | 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 $1,205 | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05943652 |
Policy instance | 1 |
Insurance contract or identification number | KM05943652 | Number of Individuals Covered | 276 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2019-03-31 | Total amount of commissions paid to insurance broker | USD $10,535 | Total amount of fees paid to insurance company | USD $726 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $82,856 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,535 | Amount paid for insurance broker fees | 726 | Insurance broker organization code? | 3 |
|
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
Policy contract number | 41837 |
Policy instance | 2 |
Insurance contract or identification number | 41837 | Number of Individuals Covered | 73 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-03-31 | Total amount of commissions paid to insurance broker | USD $719 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,985 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $719 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 3 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 100 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2019-03-31 | Total amount of commissions paid to insurance broker | USD $4,381 | Total amount of fees paid to insurance company | USD $0 | 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 $4,381 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 4 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 6 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2019-03-31 | Total amount of commissions paid to insurance broker | USD $3,791 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $25,270 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,791 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 2 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 107 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $4,437 | Total amount of fees paid to insurance company | USD $0 | 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 $4,437 | Insurance broker organization code? | 3 | Insurance broker name | M3 INSURANCE |
|
WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
Policy contract number | 41837 |
Policy instance | 3 |
Insurance contract or identification number | 41837 | Number of Individuals Covered | 79 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $709 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $709 | Insurance broker organization code? | 3 | Insurance broker name | M3 INSURANCE SOLUTIONS, INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 4 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 11 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $3,576 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $29,971 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,576 | Insurance broker organization code? | 3 | Insurance broker name | M3 INSURANCE |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05943652 |
Policy instance | 1 |
Insurance contract or identification number | KM05943652 | Number of Individuals Covered | 308 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $9,762 | Total amount of fees paid to insurance company | USD $228 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $84,199 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,752 | Amount paid for insurance broker fees | 228 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | M3 INSURANCE SOLUTIONS, INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 3 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 14 | Insurance policy start date | 2015-04-01 | Insurance policy end date | 2016-03-31 | Total amount of commissions paid to insurance broker | USD $5,277 | Total amount of fees paid to insurance company | USD $508 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $33,215 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,277 | Amount paid for insurance broker fees | 508 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | NUMEROUS |
Policy instance | 2 |
Insurance contract or identification number | NUMEROUS | Number of Individuals Covered | 225 | Insurance policy start date | 2015-04-01 | Insurance policy end date | 2016-03-31 | Total amount of commissions paid to insurance broker | USD $11,045 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LTD AND LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $86,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,045 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 1 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 121 | Insurance policy start date | 2015-04-01 | Insurance policy end date | 2016-03-31 | Total amount of commissions paid to insurance broker | USD $5,333 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,992 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,333 | Insurance broker organization code? | 3 | Insurance broker name | HAYS COMPANIES |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 3 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 17 | Insurance policy start date | 2014-04-01 | Insurance policy end date | 2015-03-31 | Total amount of commissions paid to insurance broker | USD $3,810 | Total amount of fees paid to insurance company | USD $508 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $25,947 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,810 | Amount paid for insurance broker fees | 508 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAL3I |
Policy instance | 2 |
Insurance contract or identification number | GOOOAL3I | Number of Individuals Covered | 230 | Insurance policy start date | 2014-04-01 | Insurance policy end date | 2015-03-31 | Total amount of commissions paid to insurance broker | USD $12,655 | Total amount of fees paid to insurance company | USD $2,663 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LTD AND LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $101,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,655 | Amount paid for insurance broker fees | 2663 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 1 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 115 | Insurance policy start date | 2014-04-01 | Insurance policy end date | 2015-03-31 | Total amount of commissions paid to insurance broker | USD $5,667 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,667 | Insurance broker organization code? | 3 | Insurance broker name | HAYS COMPANIES |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 3 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 23 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2014-03-31 | Total amount of commissions paid to insurance broker | USD $3,799 | Total amount of fees paid to insurance company | USD $498 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $25,176 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,799 | Amount paid for insurance broker fees | 498 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GOOOAL3I |
Policy instance | 2 |
Insurance contract or identification number | GOOOAL3I | Number of Individuals Covered | 262 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2014-03-31 | Total amount of commissions paid to insurance broker | USD $12,816 | Total amount of fees paid to insurance company | USD $4,454 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LTD AND LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $103,430 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,816 | Amount paid for insurance broker fees | 4454 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS ENEFITS GROUP OF WI LLC |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 1 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 131 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2014-03-31 | Total amount of commissions paid to insurance broker | USD $5,595 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,595 | Insurance broker organization code? | 3 | Insurance broker name | HAYS COMPANIES |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 1 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 134 | Insurance policy start date | 2012-04-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $5,572 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Commission paid to Insurance Broker | USD $5,572 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AL3I |
Policy instance | 2 |
Insurance contract or identification number | G000AL3I | Number of Individuals Covered | 264 | Insurance policy start date | 2012-04-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $10,371 | Total amount of fees paid to insurance company | USD $1,260 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY LTD AND LIFE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $78,192 | Commission paid to Insurance Broker | USD $10,371 | Amount paid for insurance broker fees | 1260 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HAYS BENEFITS GROUP OF WI |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 3 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 23 | Insurance policy start date | 2012-04-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $4,007 | Total amount of fees paid to insurance company | USD $534 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $27,144 | Commission paid to Insurance Broker | USD $4,007 | Amount paid for insurance broker fees | 534 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 146720 |
Policy instance | 4 |
Insurance contract or identification number | 146720 | Number of Individuals Covered | 262 | Insurance policy start date | 2011-04-01 | Insurance policy end date | 2012-03-31 | Total amount of commissions paid to insurance broker | USD $3,020 | Total amount of fees paid to insurance company | USD $1,050 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 146720 |
Policy instance | 3 |
Insurance contract or identification number | 146720 | Number of Individuals Covered | 127 | Insurance policy start date | 2011-04-01 | Insurance policy end date | 2012-03-31 | Total amount of commissions paid to insurance broker | USD $3,221 | Total amount of fees paid to insurance company | USD $556 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 2 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 26 | Insurance policy start date | 2011-04-01 | Insurance policy end date | 2012-03-31 | Total amount of commissions paid to insurance broker | USD $4,020 | Total amount of fees paid to insurance company | USD $84 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $26,903 |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 1 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 135 | Insurance policy start date | 2011-04-01 | Insurance policy end date | 2012-03-31 | Total amount of commissions paid to insurance broker | USD $5,589 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 949242 |
Policy instance | 1 |
Insurance contract or identification number | 949242 | Number of Individuals Covered | 28 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-03-31 | Total amount of commissions paid to insurance broker | USD $4,473 | Total amount of fees paid to insurance company | USD $173 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | GROUP LONG TERM CARE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $29,523 | Commission paid to Insurance Broker | USD $4,473 | Amount paid for insurance broker fees | 173 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
MERCYCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60215 ) |
Policy contract number | 501550 |
Policy instance | 2 |
Insurance contract or identification number | 501550 | Number of Individuals Covered | 45 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2010-07-31 | Total amount of commissions paid to insurance broker | USD $3,677 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $92,107 | Commission paid to Insurance Broker | USD $3,677 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
Policy contract number | 04504 |
Policy instance | 3 |
Insurance contract or identification number | 04504 | Number of Individuals Covered | 148 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-03-31 | Total amount of commissions paid to insurance broker | USD $6,004 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Commission paid to Insurance Broker | USD $6,004 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 146720 |
Policy instance | 4 |
Insurance contract or identification number | 146720 | Number of Individuals Covered | 136 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-03-31 | Total amount of commissions paid to insurance broker | USD $3,456 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Commission paid to Insurance Broker | USD $3,456 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 146720 |
Policy instance | 5 |
Insurance contract or identification number | 146720 | Number of Individuals Covered | 283 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-03-31 | Total amount of commissions paid to insurance broker | USD $3,076 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Commission paid to Insurance Broker | USD $3,076 | Insurance broker organization code? | 3 | Insurance broker name | THE HAYS BENEFITS GROUP OF WI LLC |
|