GENERAL WHOLESALE COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GENERAL WHOLESALE CO GP INSURANCE PLAN
Measure | Date | Value |
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2022: GENERAL WHOLESALE CO GP INSURANCE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 565 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 436 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 7 |
Total of all active and inactive participants | 2022-01-01 | 443 |
2021: GENERAL WHOLESALE CO GP INSURANCE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 589 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 565 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 5 |
Total of all active and inactive participants | 2021-01-01 | 570 |
2020: GENERAL WHOLESALE CO GP INSURANCE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 407 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 589 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 3 |
Total of all active and inactive participants | 2020-01-01 | 592 |
2019: GENERAL WHOLESALE CO GP INSURANCE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 404 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 407 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 3 |
Total of all active and inactive participants | 2019-01-01 | 410 |
2018: GENERAL WHOLESALE CO GP INSURANCE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 366 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 404 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 1 |
Total of all active and inactive participants | 2018-01-01 | 405 |
2017: GENERAL WHOLESALE CO GP INSURANCE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 327 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 366 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 3 |
Total of all active and inactive participants | 2017-01-01 | 369 |
2016: GENERAL WHOLESALE CO GP INSURANCE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 337 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 327 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 2 |
Total of all active and inactive participants | 2016-01-01 | 329 |
2015: GENERAL WHOLESALE CO GP INSURANCE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 357 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 334 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 3 |
Total of all active and inactive participants | 2015-01-01 | 337 |
2014: GENERAL WHOLESALE CO GP INSURANCE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 300 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 354 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 3 |
Total of all active and inactive participants | 2014-01-01 | 357 |
2013: GENERAL WHOLESALE CO GP INSURANCE PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 301 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 296 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 4 |
Total of all active and inactive participants | 2013-01-01 | 300 |
2012: GENERAL WHOLESALE CO GP INSURANCE PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 334 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 300 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 1 |
Total of all active and inactive participants | 2012-01-01 | 301 |
2011: GENERAL WHOLESALE CO GP INSURANCE PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 337 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 330 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 4 |
Total of all active and inactive participants | 2011-01-01 | 334 |
2009: GENERAL WHOLESALE CO GP INSURANCE PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 346 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 333 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 3 |
Total of all active and inactive participants | 2009-01-01 | 336 |
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 927253 |
Policy instance | 6 |
Insurance contract or identification number | 927253 | Number of Individuals Covered | 1305 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $17,259 | Total amount of fees paid to insurance company | USD $90,160 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,927,974 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,259 | Amount paid for insurance broker fees | 90160 | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | Insurance broker organization code? | 3 |
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ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | GA8189 |
Policy instance | 5 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 548 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $66,910 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,524,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66,910 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BJ3Q |
Policy instance | 4 |
Insurance contract or identification number | G000BJ3Q | Number of Individuals Covered | 443 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $30,072 | Total amount of fees paid to insurance company | USD $10,029 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $136,695 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,072 | Amount paid for insurance broker fees | 7355 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 884867G |
Policy instance | 3 |
Insurance contract or identification number | 884867G | Number of Individuals Covered | 312 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $8,155 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $54,365 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,155 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 2 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 450 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $4,162 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $94,799 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,162 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 548 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $73,177 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,667,918 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $73,177 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 579 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $74,239 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,698,848 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $74,239 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 2 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 465 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $4,410 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,285 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,410 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 884867G |
Policy instance | 3 |
Insurance contract or identification number | 884867G | Number of Individuals Covered | 323 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $8,554 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $57,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,554 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BJ3Q |
Policy instance | 4 |
Insurance contract or identification number | G000BJ3Q | Number of Individuals Covered | 454 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $29,421 | Total amount of fees paid to insurance company | USD $10,806 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $133,735 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,536 | Amount paid for insurance broker fees | 8105 | Insurance broker organization code? | 3 |
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ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 ) |
Policy contract number | GA8189 |
Policy instance | 5 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 579 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $68,359 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,555,703 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $68,359 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 589 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $135,244 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,126,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $135,244 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0164628 |
Policy instance | 2 |
Insurance contract or identification number | 0164628 | Number of Individuals Covered | 468 | Insurance policy start date | 2019-04-01 | Insurance policy end date | 2020-03-31 | Total amount of commissions paid to insurance broker | USD $-44 | Total amount of fees paid to insurance company | USD $174 | Other welfare benefits provided | CRITICAL ILLNESS INSURANCE, OTHER | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $-44 | Amount paid for insurance broker fees | 174 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 3 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 473 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $8,042 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $199,092 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,042 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 884867G |
Policy instance | 4 |
Insurance contract or identification number | 884867G | Number of Individuals Covered | 340 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $6,963 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,419 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,963 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BJ3Q |
Policy instance | 5 |
Insurance contract or identification number | G000BJ3Q | Number of Individuals Covered | 468 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $29,716 | Total amount of fees paid to insurance company | USD $6,025 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $135,075 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,716 | Amount paid for insurance broker fees | 6025 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 6 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 393 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $2,138 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $51,740 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,138 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 401 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $115,068 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,810,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $115,068 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0164628 |
Policy instance | 2 |
Insurance contract or identification number | 0164628 | Number of Individuals Covered | 293 | Insurance policy start date | 2018-04-01 | Insurance policy end date | 2019-03-31 | Total amount of commissions paid to insurance broker | USD $4,213 | Total amount of fees paid to insurance company | USD $1,404 | Other welfare benefits provided | CRITICAL ILLNESS INSURANCE, OTHER | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,213 | Amount paid for insurance broker fees | 1404 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 3 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 407 | Insurance policy start date | 2018-03-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $8,661 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $223,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,661 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 884867G |
Policy instance | 4 |
Insurance contract or identification number | 884867G | Number of Individuals Covered | 309 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $6,091 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,605 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,091 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000BJ3Q |
Policy instance | 5 |
Insurance contract or identification number | G000BJ3Q | Number of Individuals Covered | 443 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $25,230 | Total amount of fees paid to insurance company | USD $5,259 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114,684 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,230 | Amount paid for insurance broker fees | 5259 | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 5 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 383 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $106,123 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $184,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $106,123 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0164628 |
Policy instance | 4 |
Insurance contract or identification number | 0164628 | Number of Individuals Covered | 299 | Insurance policy start date | 2017-04-01 | Insurance policy end date | 2018-03-31 | Total amount of commissions paid to insurance broker | USD $5,573 | Total amount of fees paid to insurance company | USD $1,286 | Other welfare benefits provided | CRITICAL ILLNESS INSURANCE, OTHER | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,573 | Amount paid for insurance broker fees | 1286 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010216945 |
Policy instance | 3 |
Insurance contract or identification number | 000010216945 | Number of Individuals Covered | 394 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $7,556 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,370 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,556 | Insurance broker organization code? | 3 |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | GA2751 |
Policy instance | 2 |
Insurance contract or identification number | GA2751 | Number of Individuals Covered | 383 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $9,223 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $71,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,223 | Insurance broker organization code? | 3 |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 386 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $6,000 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,502,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6000 |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA8189 |
Policy instance | 5 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 384 | Insurance policy start date | 2016-03-01 | Insurance policy end date | 2017-02-28 | Total amount of commissions paid to insurance broker | USD $95,038 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $168,546 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $95,038 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0164628 |
Policy instance | 4 |
Insurance contract or identification number | 0164628 | Number of Individuals Covered | 305 | Insurance policy start date | 2016-04-01 | Insurance policy end date | 2017-03-31 | Total amount of commissions paid to insurance broker | USD $16,361 | Total amount of fees paid to insurance company | USD $941 | Other welfare benefits provided | CRITICAL ILLNESS INSURANCE, OTHER | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,361 | Amount paid for insurance broker fees | 941 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC DBA INTREPID |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010216945 |
Policy instance | 3 |
Insurance contract or identification number | 000010216945 | Number of Individuals Covered | 298 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $7,609 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,725 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,609 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT-RAWLS INC |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | GA2751 |
Policy instance | 2 |
Insurance contract or identification number | GA2751 | Number of Individuals Covered | 363 | Insurance policy start date | 2016-03-01 | Insurance policy end date | 2017-02-28 | Total amount of commissions paid to insurance broker | USD $5,593 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,967 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,593 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 1 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 388 | Insurance policy start date | 2016-03-01 | Insurance policy end date | 2017-02-28 | Total amount of commissions paid to insurance broker | USD $95,038 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,348,342 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $95,038 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 322 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $403 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $122,925 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $403 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228988 |
Policy instance | 3 |
Insurance contract or identification number | 228988 | Number of Individuals Covered | 272 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $4,546 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $44,419 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,546 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT SETH |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA8189 |
Policy instance | 4 |
Insurance contract or identification number | GA8189 | Number of Individuals Covered | 346 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $76,848 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,371,305 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76,848 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 334 | Insurance policy start date | 2014-08-01 | Insurance policy end date | 2015-07-31 | Total amount of commissions paid to insurance broker | USD $1,416 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,416 | Insurance broker organization code? | 3 | Insurance broker name | PAM DEBOY |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 296 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $1,300 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $126,225 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $984 | Insurance broker organization code? | 3 | Insurance broker name | ELF VENTURES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 354 | Insurance policy start date | 2013-08-01 | Insurance policy end date | 2014-07-31 | Total amount of commissions paid to insurance broker | USD $2,022 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $17,173 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,022 | Insurance broker organization code? | 3 | Insurance broker name | PAM DEBOY |
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COVENTRY HEALTH CARE OF GEORGIA (National Association of Insurance Commissioners NAIC id number: 95282 ) |
Policy contract number | 6532310000 |
Policy instance | 3 |
Insurance contract or identification number | 6532310000 | Number of Individuals Covered | 458 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $60,267 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,008,887 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,555 | Insurance broker organization code? | 3 | Insurance broker name | SEBS OF GEORGIA INC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 228988 |
Policy instance | 4 |
Insurance contract or identification number | 228988 | Number of Individuals Covered | 1350 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $3,535 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,219 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,535 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT SETH |
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CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 81973 ) |
Policy contract number | 6532310000 |
Policy instance | 5 |
Insurance contract or identification number | 6532310000 | Number of Individuals Covered | 49 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $20,853 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $175,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,090 | Insurance broker organization code? | 3 | Insurance broker name | SEBS OF GEORGIA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010080702 |
Policy instance | 4 |
Insurance contract or identification number | 000010080702 | Number of Individuals Covered | 249 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $5,155 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,366 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,715 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT-RAWLS INC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 281 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $3,287 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $126,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,417 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE INSURANCE ADVISORS,INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 296 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $1,484 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,130 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,484 | Insurance broker organization code? | 3 | Insurance broker name | PAMELA DEBOY |
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COVENTRY HEALTH CARE OF GEORGIA (National Association of Insurance Commissioners NAIC id number: 95282 ) |
Policy contract number | 6532310000 |
Policy instance | 3 |
Insurance contract or identification number | 6532310000 | Number of Individuals Covered | 468 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $82,566 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,189,884 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,738 | Insurance broker organization code? | 3 | Insurance broker name | SEBS OF GEORGIA INC |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 297 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $4,095 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $134,297 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,095 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE INSURANCE ADVISORS,INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 300 | Insurance policy start date | 2011-08-01 | Insurance policy end date | 2012-07-31 | Total amount of commissions paid to insurance broker | USD $1,219 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,219 | Insurance broker organization code? | 3 | Insurance broker name | PAMELA DEBOY |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716424 |
Policy instance | 3 |
Insurance contract or identification number | 0716424 | Number of Individuals Covered | 571 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $69,053 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,140,664 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,053 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE INSURANCE ADVISORS,INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010080702 |
Policy instance | 4 |
Insurance contract or identification number | 000010080702 | Number of Individuals Covered | 243 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $5,400 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,001 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,400 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT-MIZE, INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716424 |
Policy instance | 3 |
Insurance contract or identification number | 0716424 | Number of Individuals Covered | 571 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $78,863 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,067,708 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 330 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2011-07-31 | Total amount of commissions paid to insurance broker | USD $1,816 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $17,872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010080702 |
Policy instance | 4 |
Insurance contract or identification number | 000010080702 | Number of Individuals Covered | 266 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $5,606 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,375 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 313 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $4,021 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $128,424 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010080702 |
Policy instance | 4 |
Insurance contract or identification number | 000010080702 | Number of Individuals Covered | 263 | Insurance policy start date | 2009-05-01 | Insurance policy end date | 2010-04-30 | Total amount of commissions paid to insurance broker | USD $5,408 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,053 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,408 | Insurance broker organization code? | 3 | Insurance broker name | KNIGHT-MIZE, INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0716424 |
Policy instance | 3 |
Insurance contract or identification number | 0716424 | Number of Individuals Covered | 546 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $74,103 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,015,238 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $74,103 | Insurance broker organization code? | 3 | Insurance broker name | CORP INS ADVISORS,INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 300904 |
Policy instance | 2 |
Insurance contract or identification number | 300904 | Number of Individuals Covered | 328 | Insurance policy start date | 2009-12-01 | Insurance policy end date | 2010-11-30 | Total amount of commissions paid to insurance broker | USD $1,804 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $17,750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,804 | Insurance broker name | PAM DEBOY |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-098473 |
Policy instance | 1 |
Insurance contract or identification number | 010-098473 | Number of Individuals Covered | 312 | Insurance policy start date | 2009-02-01 | Insurance policy end date | 2010-01-31 | Total amount of commissions paid to insurance broker | USD $4,084 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $133,930 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,084 | Insurance broker organization code? | 3 | Insurance broker name | CORP INS ADVISORS,INC |
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