BLUE CROSS BLUE SHIELD OF NORTH DAKOTA has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022: GROUP LIFE INSURANCE PROGRAM 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 2,608 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 806 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 806 |
| 2021: GROUP LIFE INSURANCE PROGRAM 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2,489 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 2,608 |
| Total of all active and inactive participants | 2021-01-01 | 2,608 |
| Total participants | 2021-01-01 | 2,608 |
| 2019: GROUP LIFE INSURANCE PROGRAM 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 2,518 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 2,572 |
| Total of all active and inactive participants | 2019-01-01 | 2,572 |
| Total participants | 2019-01-01 | 2,572 |
| 2018: GROUP LIFE INSURANCE PROGRAM 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 2,455 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 2,518 |
| Total of all active and inactive participants | 2018-01-01 | 2,518 |
| Total participants | 2018-01-01 | 2,518 |
| 2017: GROUP LIFE INSURANCE PROGRAM 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 2,587 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 2,455 |
| Total of all active and inactive participants | 2017-01-01 | 2,455 |
| Total participants | 2017-01-01 | 2,455 |
| 2016: GROUP LIFE INSURANCE PROGRAM 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 2,651 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 2,587 |
| Total of all active and inactive participants | 2016-01-01 | 2,587 |
| Total participants | 2016-01-01 | 2,587 |
| 2015: GROUP LIFE INSURANCE PROGRAM 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2,721 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 2,651 |
| Total of all active and inactive participants | 2015-01-01 | 2,651 |
| Total participants | 2015-01-01 | 2,651 |
| 2014: GROUP LIFE INSURANCE PROGRAM 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 2,672 |
| Total of all active and inactive participants | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 0 |
| 2013: GROUP LIFE INSURANCE PROGRAM 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,864 |
| Total of all active and inactive participants | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 0 |
| 2012: GROUP LIFE INSURANCE PROGRAM 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 1,634 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,864 |
| Total of all active and inactive participants | 2012-01-01 | 1,864 |
| Total participants | 2012-01-01 | 1,864 |
| 2011: GROUP LIFE INSURANCE PROGRAM 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 1,518 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,634 |
| Total of all active and inactive participants | 2011-01-01 | 1,634 |
| Total participants | 2011-01-01 | 1,634 |
| 2010: GROUP LIFE INSURANCE PROGRAM 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 2,182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 1,518 |
| Total of all active and inactive participants | 2010-01-01 | 1,518 |
| Total participants | 2010-01-01 | 1,518 |
| 2009: GROUP LIFE INSURANCE PROGRAM 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 166 |
| Total of all active and inactive participants | 2009-01-01 | 166 |
| Total participants | 2009-01-01 | 166 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 310 |
| 2022: GROUP LIFE INSURANCE PROGRAM 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: GROUP LIFE INSURANCE PROGRAM 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE INSURANCE PROGRAM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE INSURANCE PROGRAM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE INSURANCE PROGRAM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP LIFE INSURANCE PROGRAM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP LIFE INSURANCE PROGRAM 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE INSURANCE PROGRAM 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP LIFE INSURANCE PROGRAM 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP LIFE INSURANCE PROGRAM 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP LIFE INSURANCE PROGRAM 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP LIFE INSURANCE PROGRAM 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP LIFE INSURANCE PROGRAM 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | First time form 5500 has been submitted | Yes |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 2 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 1076 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $97,027 | | Are there contracts with allocated funds for individual policies? | 0 | | 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 | | Other welfare benefits provided | AD&D | | 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 $557,279 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 97027 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 1 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 5087 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $192,214 | | Are there contracts with allocated funds for individual policies? | 0 | | 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 | AD&D | | 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 $1,304,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 192214 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000098192 |
| Policy instance | 3 |
| Insurance contract or identification number | 000000098192 | | Number of Individuals Covered | 984 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $102,138 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $537,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 102138 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | 632748 |
| Policy instance | 2 |
| Insurance contract or identification number | 632748 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $42,941 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $357,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 42941 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000098199 |
| Policy instance | 1 |
| Insurance contract or identification number | 000000098199 | | Number of Individuals Covered | 4821 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of fees paid to insurance company | USD $192,588 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,319,518 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 192588 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 949 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $84,799 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $432,265 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 84799 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0008824287 |
| Policy instance | 2 |
| Insurance contract or identification number | 0008824287 | | Number of Individuals Covered | 584 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $19,449 | | Total amount of fees paid to insurance company | USD $605 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $172,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,323 | | Amount paid for insurance broker fees | 605 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 3 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 4872 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of fees paid to insurance company | USD $197,863 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,248,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 197863 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0287474 |
| Policy instance | 4 |
| Insurance contract or identification number | R0287474 | | Number of Individuals Covered | 926 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $54,563 | | Total amount of fees paid to insurance company | USD $1,922 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $332,354 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $54,119 | | Amount paid for insurance broker fees | 1922 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 2 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 2360 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $169,852 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $820,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 169852 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 2248 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of fees paid to insurance company | USD $81,189 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $662,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 81189 | | Additional information about fees paid to insurance broker | OTHER ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 2 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 1641 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of fees paid to insurance company | USD $180,821 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,239,489 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 180821 | | Additional information about fees paid to insurance broker | OTHER ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2018-01-01 | | Total amount of fees paid to insurance company | USD $59,131 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $311,768 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 59131 | | Additional information about fees paid to insurance broker | OTHER ADDITIONAL COMPENSATION PAID | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 2 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 3097 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $169,615 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $903,608 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $169,615 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $56,897 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $278,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,897 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 2 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 3310 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $136,373 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $779,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $136,373 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 494 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $48,880 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $278,269 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,880 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $47,451 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $233,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $47,451 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC. |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 2 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 2672 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $107,231 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $528,834 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $107,231 | | Insurance broker organization code? | 3 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 8184200 |
| Policy instance | 2 |
| Insurance contract or identification number | 8184200 | | Number of Individuals Covered | 1757 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $591,277 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098199 |
| Policy instance | 3 |
| Insurance contract or identification number | 098199 | | Number of Individuals Covered | 2097 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-01-01 | | Total amount of commissions paid to insurance broker | USD $60,283 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $296,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,283 | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098192 |
| Policy instance | 1 |
| Insurance contract or identification number | 098192 | | Number of Individuals Covered | 711 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-01-01 | | Total amount of commissions paid to insurance broker | USD $20,960 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $108,391 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,960 | | Insurance broker name | NORIDIAN INSURANCE SERVICES, INC |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 2214700 |
| Policy instance | 1 |
| Insurance contract or identification number | 2214700 | | Number of Individuals Covered | 1517 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $26,545 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $227,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 8184200 |
| Policy instance | 2 |
| Insurance contract or identification number | 8184200 | | Number of Individuals Covered | 761 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-04-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $318,707 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 2214700 |
| Policy instance | 1 |
| Insurance contract or identification number | 2214700 | | Number of Individuals Covered | 735 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $23,988 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $229,853 |
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| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 8184200 |
| Policy instance | 2 |
| Insurance contract or identification number | 8184200 | | Number of Individuals Covered | 1518 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-04-30 | | Welfare Benefit Premiums Paid to Carrier | USD $554,518 |
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