BERRY COLLEGE, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE
401k plan membership statisitcs for GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE
| Measure | Date | Value |
|---|
| 2022: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 547 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 550 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 550 |
| Number of employers contributing to the scheme | 2022-07-01 | 0 |
| 2021: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 779 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 547 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 151 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 698 |
| Number of employers contributing to the scheme | 2021-07-01 | 0 |
| 2020: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 720 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 532 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 247 |
| Total of all active and inactive participants | 2020-07-01 | 779 |
| 2019: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 690 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 547 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 173 |
| Total of all active and inactive participants | 2019-07-01 | 720 |
| 2018: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 709 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 547 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 143 |
| Total of all active and inactive participants | 2018-07-01 | 690 |
| 2017: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 702 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 571 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 138 |
| Total of all active and inactive participants | 2017-07-01 | 709 |
| 2016: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 817 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 573 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 129 |
| Total of all active and inactive participants | 2016-07-01 | 702 |
| 2015: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 770 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 688 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 129 |
| Total of all active and inactive participants | 2015-07-01 | 817 |
| 2014: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 758 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 660 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 110 |
| Total of all active and inactive participants | 2014-07-01 | 770 |
| 2013: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 638 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 660 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 98 |
| Total of all active and inactive participants | 2013-07-01 | 758 |
| 2012: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 630 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 539 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 99 |
| Total of all active and inactive participants | 2012-07-01 | 638 |
| Total participants | 2012-07-01 | 638 |
| 2011: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 630 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 526 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 104 |
| Total of all active and inactive participants | 2011-07-01 | 630 |
| Total participants | 2011-07-01 | 630 |
| 2010: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-07-01 | 620 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 526 |
| Number of retired or separated participants receiving benefits | 2010-07-01 | 104 |
| Total of all active and inactive participants | 2010-07-01 | 630 |
| Total participants | 2010-07-01 | 630 |
| 2009: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 609 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 519 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 101 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 620 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-07-01 | 0 |
| Total participants | 2009-07-01 | 620 |
| 2022: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | No |
| 2020-07-01 | This submission is the final filing | No |
| 2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-07-01 | Plan is a collectively bargained plan | No |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Submission has been amended | No |
| 2019-07-01 | This submission is the final filing | No |
| 2019-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-07-01 | Plan is a collectively bargained plan | No |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Submission has been amended | No |
| 2018-07-01 | This submission is the final filing | No |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-07-01 | Plan is a collectively bargained plan | No |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2010 form 5500 responses |
|---|
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Submission has been amended | No |
| 2010-07-01 | This submission is the final filing | No |
| 2010-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-07-01 | Plan is a collectively bargained plan | No |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP INSURANCE PLAN FOR ACTIVE AND RETIRED EMPLOYEES OF BERRY COLLEGE 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 069164 |
| Policy instance | 4 |
| Insurance contract or identification number | 069164 | | Number of Individuals Covered | 550 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $20,108 | | Total amount of fees paid to insurance company | USD $6,917 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | CRITICAL ILLNESS,ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $319,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,108 | | Amount paid for insurance broker fees | 6917 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 3 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $62,452 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $400,267 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,193 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 5 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 8383323 |
| Policy instance | 2 |
| Insurance contract or identification number | 8383323 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $107 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $7,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $107 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7199 |
| Policy instance | 1 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 1177 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $213,398 | | Total amount of fees paid to insurance company | USD $8,188 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,037,418 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $213,398 | | Amount paid for insurance broker fees | 8188 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 3 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 151 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $57,512 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $369,393 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $45,653 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 5 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7199 |
| Policy instance | 1 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 701 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $214,916 | | Total amount of fees paid to insurance company | USD $10,527 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,773,308 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $214,916 | | Amount paid for insurance broker fees | 10527 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 8383323 |
| Policy instance | 2 |
| Insurance contract or identification number | 8383323 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $141 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENT, CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $9,308 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $141 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0342634 |
| Policy instance | 4 |
| Insurance contract or identification number | R0342634 | | Number of Individuals Covered | 547 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $9,558 | | Total amount of fees paid to insurance company | USD $4,921 | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | CRITICAL ILLNESS,ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $278,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,558 | | Amount paid for insurance broker fees | 4921 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7199 |
| Policy instance | 3 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 685 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $213,094 | | Total amount of fees paid to insurance company | USD $17,016 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,504,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $213,094 | | Amount paid for insurance broker fees | 17016 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| WELLNET HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | 24513 |
| Policy instance | 1 |
| Insurance contract or identification number | 24513 | | Number of Individuals Covered | 746 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $34,912 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,599,635 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,912 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 8383323 |
| Policy instance | 6 |
| Insurance contract or identification number | 8383323 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $205 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT, ISWL STND | | Welfare Benefit Premiums Paid to Carrier | USD $9,404 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $205 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 69164 |
| Policy instance | 7 |
| Insurance contract or identification number | 69164 | | Number of Individuals Covered | 532 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $9,620 | | Total amount of fees paid to insurance company | USD $6,238 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $287,680 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,620 | | Amount paid for insurance broker fees | 6238 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0342634 |
| Policy instance | 4 |
| Insurance contract or identification number | R0342634 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $515 | | Total amount of fees paid to insurance company | USD $10 | | Other welfare benefits provided | GCIEE | | Welfare Benefit Premiums Paid to Carrier | USD $9,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $515 | | Amount paid for insurance broker fees | 10 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 69180 |
| Policy instance | 2 |
| Insurance contract or identification number | 69180 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $9,099 | | Total amount of fees paid to insurance company | USD $1,213 | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $65,676 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,099 | | Amount paid for insurance broker fees | 1213 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 5 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 296 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $67,827 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $363,890 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,481 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 5 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA7199 |
| Policy instance | 6 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 685 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $218,811 | | Total amount of fees paid to insurance company | USD $3,724 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,835,140 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $180,168 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3724 | | Additional information about fees paid to insurance broker | BONUS |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 69180 |
| Policy instance | 5 |
| Insurance contract or identification number | 69180 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $9,636 | | Total amount of fees paid to insurance company | USD $1,285 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $69,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,636 | | Amount paid for insurance broker fees | 1285 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| WELLNET HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | 24513 |
| Policy instance | 4 |
| Insurance contract or identification number | 24513 | | Number of Individuals Covered | 747 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,555,737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 3 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $68,534 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $334,398 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,624 | | Insurance broker organization code? | 5 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 8383323 |
| Policy instance | 1 |
| Insurance contract or identification number | 8383323 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $210 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENT, ISWL STND | | Welfare Benefit Premiums Paid to Carrier | USD $11,335 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $210 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 8383323 |
| Policy instance | 2 |
| Insurance contract or identification number | 8383323 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-05-01 | | Total amount of commissions paid to insurance broker | USD $420 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | STD SELF INSURED | | Welfare Benefit Premiums Paid to Carrier | USD $11,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $420 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 69164 |
| Policy instance | 7 |
| Insurance contract or identification number | 69164 | | Number of Individuals Covered | 547 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $9,263 | | Total amount of fees paid to insurance company | USD $5,213 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $284,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,263 | | Amount paid for insurance broker fees | 5213 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| WELLNET HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | 24513 |
| Policy instance | 5 |
| Insurance contract or identification number | 24513 | | Number of Individuals Covered | 759 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | GA7199 |
| Policy instance | 4 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 680 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $199,263 | | Total amount of fees paid to insurance company | USD $4,735 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,559,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $199,263 | | Amount paid for insurance broker fees | 4735 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 3 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $54,274 | | Total amount of fees paid to insurance company | USD $13,736 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $331,425 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,641 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 5 | | Additional information about fees paid to insurance broker | CLAIMS ADJUDICATION |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 069180 |
| Policy instance | 2 |
| Insurance contract or identification number | 069180 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $9,306 | | Total amount of fees paid to insurance company | USD $1,241 | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $62,037 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,306 | | Amount paid for insurance broker fees | 1241 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 069164 |
| Policy instance | 1 |
| Insurance contract or identification number | 069164 | | Number of Individuals Covered | 547 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $9,539 | | Total amount of fees paid to insurance company | USD $6,004 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $300,222 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,539 | | Amount paid for insurance broker fees | 6004 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | GA7199 |
| Policy instance | 2 |
| Insurance contract or identification number | GA7199 | | Number of Individuals Covered | 681 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $218,846 | | Total amount of fees paid to insurance company | USD $8,745 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,482,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 069164 |
| Policy instance | 3 |
| Insurance contract or identification number | 069164 | | Number of Individuals Covered | 571 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $9,357 | | Total amount of fees paid to insurance company | USD $5,484 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $274,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 069180 |
| Policy instance | 4 |
| Insurance contract or identification number | 069180 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $9,225 | | Total amount of fees paid to insurance company | USD $1,230 | | Other welfare benefits provided | VOLUNTARY LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $61,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 002603/003706 |
| Policy instance | 5 |
| Insurance contract or identification number | 002603/003706 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $31,774 | | Total amount of fees paid to insurance company | USD $13,351 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $303,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLNET HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | WNHC 1306/1307 |
| Policy instance | 1 |
| Insurance contract or identification number | WNHC 1306/1307 | | Number of Individuals Covered | 538 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
