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SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 401k Plan overview

Plan NameSOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST
Plan identification number 501

SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION
Employer identification number (EIN):576022671
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-08-01
5012021-08-01
5012020-08-01
5012019-08-01

Plan Statistics for SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST

401k plan membership statisitcs for SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST

Measure Date Value
2022: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2022 401k membership
Total participants, beginning-of-year2022-08-01328
Total number of active participants reported on line 7a of the Form 55002022-08-01331
Number of retired or separated participants receiving benefits2022-08-010
Number of other retired or separated participants entitled to future benefits2022-08-010
Total of all active and inactive participants2022-08-01331
2021: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2021 401k membership
Total participants, beginning-of-year2021-08-01335
Total number of active participants reported on line 7a of the Form 55002021-08-01327
Number of retired or separated participants receiving benefits2021-08-011
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01328
2020: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2020 401k membership
Total participants, beginning-of-year2020-08-01251
Total number of active participants reported on line 7a of the Form 55002020-08-01335
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01335
2019: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2019 401k membership
Total participants, beginning-of-year2019-08-01233
Total number of active participants reported on line 7a of the Form 55002019-08-01251
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01251

Financial Data on SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST

Measure Date Value
2023 : SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-07-31$103,990
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-07-31$133,834
Total income from all sources (including contributions)2023-07-31$3,918,454
Total loss/gain on sale of assets2023-07-31$0
Total of all expenses incurred2023-07-31$3,921,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-07-31$3,898,955
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-07-31$3,918,454
Value of total assets at end of year2023-07-31$100,957
Value of total assets at beginning of year2023-07-31$134,255
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-07-31$22,953
Total interest from all sources2023-07-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-07-31No
Administrative expenses professional fees incurred2023-07-31$16,720
Was this plan covered by a fidelity bond2023-07-31Yes
Value of fidelity bond cover2023-07-31$500,000
If this is an individual account plan, was there a blackout period2023-07-31No
Were there any nonexempt tranactions with any party-in-interest2023-07-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-07-31$5,197
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-07-31$1,358
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-07-31$103,520
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-07-31$64,283
Administrative expenses (other) incurred2023-07-31$6,233
Liabilities. Value of operating payables at end of year2023-07-31$470
Liabilities. Value of operating payables at beginning of year2023-07-31$475
Total non interest bearing cash at end of year2023-07-31$95,760
Total non interest bearing cash at beginning of year2023-07-31$132,496
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-07-31No
Value of net income/loss2023-07-31$-3,454
Value of net assets at end of year (total assets less liabilities)2023-07-31$-3,033
Value of net assets at beginning of year (total assets less liabilities)2023-07-31$421
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-07-31No
Were any leases to which the plan was party in default or uncollectible2023-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2023-07-31$3,898,955
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-07-31No
Was there a failure to transmit to the plan any participant contributions2023-07-31No
Has the plan failed to provide any benefit when due under the plan2023-07-31No
Contributions received in cash from employer2023-07-31$3,918,454
Employer contributions (assets) at end of year2023-07-31$0
Employer contributions (assets) at beginning of year2023-07-31$401
Liabilities. Value of benefit claims payable at end of year2023-07-31$0
Liabilities. Value of benefit claims payable at beginning of year2023-07-31$69,076
Did the plan have assets held for investment2023-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-07-31No
Opinion of an independent qualified public accountant for this plan2023-07-31Unqualified
Accountancy firm name2023-07-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2023-07-31410746749
2022 : SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-07-31$133,834
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-07-31$72,436
Total income from all sources (including contributions)2022-07-31$3,780,492
Total loss/gain on sale of assets2022-07-31$0
Total of all expenses incurred2022-07-31$3,779,086
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-07-31$3,758,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-07-31$3,764,892
Value of total assets at end of year2022-07-31$134,255
Value of total assets at beginning of year2022-07-31$71,451
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-07-31$20,694
Total interest from all sources2022-07-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-07-31No
Administrative expenses professional fees incurred2022-07-31$14,751
Was this plan covered by a fidelity bond2022-07-31Yes
Value of fidelity bond cover2022-07-31$500,000
If this is an individual account plan, was there a blackout period2022-07-31No
Were there any nonexempt tranactions with any party-in-interest2022-07-31No
Contributions received from participants2022-07-31$11,231
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-07-31$1,358
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-07-31$973
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-07-31$64,283
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-07-31$3,438
Other income not declared elsewhere2022-07-31$15,600
Administrative expenses (other) incurred2022-07-31$5,943
Liabilities. Value of operating payables at end of year2022-07-31$475
Liabilities. Value of operating payables at beginning of year2022-07-31$0
Total non interest bearing cash at end of year2022-07-31$132,496
Total non interest bearing cash at beginning of year2022-07-31$70,478
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-07-31No
Value of net income/loss2022-07-31$1,406
Value of net assets at end of year (total assets less liabilities)2022-07-31$421
Value of net assets at beginning of year (total assets less liabilities)2022-07-31$-985
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-07-31No
Were any leases to which the plan was party in default or uncollectible2022-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-07-31$3,758,392
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-07-31No
Was there a failure to transmit to the plan any participant contributions2022-07-31No
Has the plan failed to provide any benefit when due under the plan2022-07-31No
Contributions received in cash from employer2022-07-31$3,753,661
Employer contributions (assets) at end of year2022-07-31$401
Employer contributions (assets) at beginning of year2022-07-31$0
Liabilities. Value of benefit claims payable at end of year2022-07-31$69,076
Liabilities. Value of benefit claims payable at beginning of year2022-07-31$68,998
Did the plan have assets held for investment2022-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-07-31No
Opinion of an independent qualified public accountant for this plan2022-07-31Unqualified
Accountancy firm name2022-07-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-07-31410746749
2021 : SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-07-31$72,436
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-07-31$181,548
Total income from all sources (including contributions)2021-07-31$3,431,652
Total loss/gain on sale of assets2021-07-31$0
Total of all expenses incurred2021-07-31$3,432,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-07-31$3,417,252
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-07-31$3,431,652
Value of total assets at end of year2021-07-31$71,451
Value of total assets at beginning of year2021-07-31$181,122
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-07-31$14,959
Total interest from all sources2021-07-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-07-31No
Administrative expenses professional fees incurred2021-07-31$9,188
Was this plan covered by a fidelity bond2021-07-31No
If this is an individual account plan, was there a blackout period2021-07-31No
Were there any nonexempt tranactions with any party-in-interest2021-07-31No
Contributions received from participants2021-07-31$2,888
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-07-31$973
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-07-31$871
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-07-31$3,438
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-07-31$174,807
Administrative expenses (other) incurred2021-07-31$5,771
Total non interest bearing cash at end of year2021-07-31$70,478
Total non interest bearing cash at beginning of year2021-07-31$180,251
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-07-31No
Value of net income/loss2021-07-31$-559
Value of net assets at end of year (total assets less liabilities)2021-07-31$-985
Value of net assets at beginning of year (total assets less liabilities)2021-07-31$-426
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-07-31No
Were any leases to which the plan was party in default or uncollectible2021-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-07-31$3,417,252
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-07-31No
Was there a failure to transmit to the plan any participant contributions2021-07-31No
Has the plan failed to provide any benefit when due under the plan2021-07-31No
Contributions received in cash from employer2021-07-31$3,428,764
Liabilities. Value of benefit claims payable at end of year2021-07-31$68,998
Liabilities. Value of benefit claims payable at beginning of year2021-07-31$6,741
Did the plan have assets held for investment2021-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-07-31No
Opinion of an independent qualified public accountant for this plan2021-07-31Unqualified
Accountancy firm name2021-07-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2021-07-31410746749
2020 : SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-07-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-31$181,548
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-31$58,748
Total income from all sources (including contributions)2020-07-31$2,808,178
Total loss/gain on sale of assets2020-07-31$0
Total of all expenses incurred2020-07-31$2,822,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-07-31$2,789,978
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-07-31$2,808,178
Value of total assets at end of year2020-07-31$181,122
Value of total assets at beginning of year2020-07-31$72,515
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-07-31$32,393
Total interest from all sources2020-07-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-07-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-07-31No
Administrative expenses professional fees incurred2020-07-31$23,525
Was this plan covered by a fidelity bond2020-07-31No
If this is an individual account plan, was there a blackout period2020-07-31No
Were there any nonexempt tranactions with any party-in-interest2020-07-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-07-31$871
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-07-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-07-31$174,807
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-07-31$58,748
Administrative expenses (other) incurred2020-07-31$8,868
Total non interest bearing cash at end of year2020-07-31$180,251
Total non interest bearing cash at beginning of year2020-07-31$72,515
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-31No
Value of net income/loss2020-07-31$-14,193
Value of net assets at end of year (total assets less liabilities)2020-07-31$-426
Value of net assets at beginning of year (total assets less liabilities)2020-07-31$13,767
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-07-31No
Were any leases to which the plan was party in default or uncollectible2020-07-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-07-31$2,789,978
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-07-31No
Was there a failure to transmit to the plan any participant contributions2020-07-31No
Has the plan failed to provide any benefit when due under the plan2020-07-31No
Contributions received in cash from employer2020-07-31$2,808,178
Liabilities. Value of benefit claims payable at end of year2020-07-31$6,741
Liabilities. Value of benefit claims payable at beginning of year2020-07-31$0
Did the plan have assets held for investment2020-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-07-31No
Opinion of an independent qualified public accountant for this plan2020-07-31Unqualified
Accountancy firm name2020-07-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-07-31410746749

Form 5500 Responses for SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST

2022: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2022 form 5500 responses
2022-08-01Type of plan entityMulitple employer plan
2022-08-01Submission has been amendedNo
2022-08-01This submission is the final filingNo
2022-08-01This return/report is a short plan year return/report (less than 12 months)No
2022-08-01Plan is a collectively bargained planNo
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan funding arrangement – TrustYes
2022-08-01Plan benefit arrangement – InsuranceYes
2022-08-01Plan benefit arrangement - TrustYes
2021: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2021 form 5500 responses
2021-08-01Type of plan entityMulitple employer plan
2021-08-01Submission has been amendedNo
2021-08-01This submission is the final filingNo
2021-08-01This return/report is a short plan year return/report (less than 12 months)No
2021-08-01Plan is a collectively bargained planNo
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – TrustYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement - TrustYes
2020: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2020 form 5500 responses
2020-08-01Type of plan entityMulitple employer plan
2020-08-01Submission has been amendedNo
2020-08-01This submission is the final filingNo
2020-08-01This return/report is a short plan year return/report (less than 12 months)No
2020-08-01Plan is a collectively bargained planNo
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – TrustYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement - TrustYes
2019: SOUTH CAROLINA STATE FIREFIGHTERS' ASSOCIATION GROUP INSURANCE TRUST 2019 form 5500 responses
2019-08-01Type of plan entityMulitple employer plan
2019-08-01Submission has been amendedNo
2019-08-01This submission is the final filingNo
2019-08-01This return/report is a short plan year return/report (less than 12 months)No
2019-08-01Plan is a collectively bargained planNo
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – TrustYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-87020-00
Policy instance 1
Insurance contract or identification number26-87020-00
Number of Individuals Covered331
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered143
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $1,379
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $8,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $550
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-87020-00
Policy instance 1
Insurance contract or identification number26-87020-00
Number of Individuals Covered327
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered143
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $1,410
Total amount of fees paid to insurance companyUSD $0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $8,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $513
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-87020-00
Policy instance 1
Insurance contract or identification number26-87020-00
Number of Individuals Covered335
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered136
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,347
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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 CarrierUSD $7,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees509
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-87020-00
Policy instance 1
Insurance contract or identification number26-87020-00
Number of Individuals Covered251
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVARIOUS
Policy instance 2
Insurance contract or identification numberVARIOUS
Number of Individuals Covered120
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,397
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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
Amount paid for insurance broker fees515
Additional information about fees paid to insurance brokerCOMPENSATION
Insurance broker organization code?3

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