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UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 401k Plan overview

Plan NameUNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN
Plan identification number 502

UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

UNITED CEREBRAL PALSY OF CENTRAL FLORIDA, has sponsored the creation of one or more 401k plans.

Company Name:UNITED CEREBRAL PALSY OF CENTRAL FLORIDA,
Employer identification number (EIN):590799925
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-10-01ILENE WILKINS2024-02-14
5022021-10-01ILENE WILKINS2023-03-13
5022021-10-01ILENE WILKINS2024-02-14
5022020-10-01ILENE WILKINS2022-04-22
5022020-10-01ILENE WILKINS2024-02-14
5022019-10-01ILENE WILKINS2021-05-04
5022019-10-01ILENE WILKINS2024-02-14
5022018-10-01ILENE WILKINS2020-07-07
5022018-10-01ILENE WILKINS2024-02-14
5022017-10-01ILENE WILKINS2019-04-26
5022017-10-01ILENE WILKINS2024-02-14
5022016-10-01
5022015-10-01ILENE WILKINS
5022014-10-01ILENE WILKINS
5022013-10-01JERRY GRIFFING
5022012-10-01JERRY GRIFFING
5022011-10-01JERRY GRIFFING
5022010-10-01JERRY GRIFFING

Plan Statistics for UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN

401k plan membership statisitcs for UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN

Measure Date Value
2022: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01501
Total number of active participants reported on line 7a of the Form 55002022-10-01476
Number of retired or separated participants receiving benefits2022-10-012
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01478
Number of employers contributing to the scheme2022-10-010
2021: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01455
Total number of active participants reported on line 7a of the Form 55002021-10-01501
Number of retired or separated participants receiving benefits2021-10-017
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01508
Number of employers contributing to the scheme2021-10-010
2020: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01350
Total number of active participants reported on line 7a of the Form 55002020-10-01455
Number of retired or separated participants receiving benefits2020-10-015
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01460
Number of employers contributing to the scheme2020-10-010
2019: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01378
Total number of active participants reported on line 7a of the Form 55002019-10-01350
Number of retired or separated participants receiving benefits2019-10-012
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01352
Number of employers contributing to the scheme2019-10-010
2018: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01368
Total number of active participants reported on line 7a of the Form 55002018-10-01378
Number of retired or separated participants receiving benefits2018-10-012
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01380
Number of employers contributing to the scheme2018-10-010
2017: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01328
Total number of active participants reported on line 7a of the Form 55002017-10-01346
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01346
Number of employers contributing to the scheme2017-10-010
2016: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01317
Total number of active participants reported on line 7a of the Form 55002016-10-01328
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01328
2015: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01193
Total number of active participants reported on line 7a of the Form 55002015-10-01317
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01317
2014: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01188
Total number of active participants reported on line 7a of the Form 55002014-10-01192
Number of retired or separated participants receiving benefits2014-10-011
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01193
2013: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01212
Total number of active participants reported on line 7a of the Form 55002013-10-01210
Number of retired or separated participants receiving benefits2013-10-012
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01212
2012: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01115
Total number of active participants reported on line 7a of the Form 55002012-10-01120
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01120
2011: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01110
Total number of active participants reported on line 7a of the Form 55002011-10-01115
Number of retired or separated participants receiving benefits2011-10-010
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01115
2010: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-01100
Total number of active participants reported on line 7a of the Form 55002010-10-01105
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-010
Total of all active and inactive participants2010-10-01105

Form 5500 Responses for UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN

2022: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – InsuranceYes
2021: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Submission has been amendedYes
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – InsuranceYes
2020: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Submission has been amendedYes
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Submission has been amendedYes
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Submission has been amendedYes
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedYes
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2010: UNITED CEREBRAL PALSY OF CENTRAL FLORIDA WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01First time form 5500 has been submittedYes
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – General assets of the sponsorYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX0970230
Policy instance 4
Insurance contract or identification numberFLX0970230
Number of Individuals Covered476
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $4,442
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $43,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,442
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number626924
Policy instance 3
Insurance contract or identification number626924
Number of Individuals Covered366
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $11,264
Total amount of fees paid to insurance companyUSD $131,505
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $3,422,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,264
Amount paid for insurance broker fees131505
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEE, INCENTIVE COMPENSATION
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 2
Insurance contract or identification numberE4344313
Number of Individuals Covered78
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $5,110
Total amount of fees paid to insurance companyUSD $281
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $47,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,163
Amount paid for insurance broker fees123
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 1
Insurance contract or identification number1068797
Number of Individuals Covered182
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $5,738
Total amount of fees paid to insurance companyUSD $1,037
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,738
Amount paid for insurance broker fees1037
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 1
Insurance contract or identification number1068797
Number of Individuals Covered108
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $5,150
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,150
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 2
Insurance contract or identification numberE4344313
Number of Individuals Covered85
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $6,874
Total amount of fees paid to insurance companyUSD $401
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $55,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,916
Amount paid for insurance broker fees21
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number626924
Policy instance 3
Insurance contract or identification number626924
Number of Individuals Covered375
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $119,668
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,198,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees119668
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEE, INCENTIVE COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number305244
Policy instance 4
Insurance contract or identification number305244
Number of Individuals Covered501
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $14,855
Total amount of fees paid to insurance companyUSD $4,362
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $151,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,855
Amount paid for insurance broker fees4362
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number305244
Policy instance 4
Insurance contract or identification number305244
Number of Individuals Covered498
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $11,002
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $127,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,498
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number626924
Policy instance 3
Insurance contract or identification number626924
Number of Individuals Covered369
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $116,322
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,762,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees116322
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEE INCENTIVE COMPENSATION
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 2
Insurance contract or identification numberE4344313
Number of Individuals Covered99
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $6,465
Total amount of fees paid to insurance companyUSD $492
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $53,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,751
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 1
Insurance contract or identification number1068797
Number of Individuals Covered165
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $4,866
Total amount of fees paid to insurance companyUSD $896
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,866
Amount paid for insurance broker fees896
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number626924
Policy instance 5
Insurance contract or identification number626924
Number of Individuals Covered350
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $92,314
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,215,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees92314
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEE
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 4
Insurance contract or identification numberE4344313
Number of Individuals Covered115
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $12,656
Total amount of fees paid to insurance companyUSD $2,587
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $72,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,667
Amount paid for insurance broker fees1028
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 3
Insurance contract or identification number1068797
Number of Individuals Covered169
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $4,502
Total amount of fees paid to insurance companyUSD $1,078
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,502
Amount paid for insurance broker fees1078
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number305244
Policy instance 2
Insurance contract or identification number305244
Number of Individuals Covered455
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $3,056
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $27,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,056
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number752474
Policy instance 1
Insurance contract or identification number752474
Number of Individuals Covered420
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $9,496
Total amount of fees paid to insurance companyUSD $4,491
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,496
Amount paid for insurance broker fees4479
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT BONUS
Insurance broker organization code?3
Vision Insurance Welfare BenefitYes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number752474
Policy instance 1
Insurance contract or identification number752474
Number of Individuals Covered389
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $8,793
Total amount of fees paid to insurance companyUSD $96,277
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,303,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,793
Amount paid for insurance broker fees96277
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT BONUS
Insurance broker organization code?3
Vision Insurance Welfare BenefitYes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number305244
Policy instance 2
Insurance contract or identification number305244
Number of Individuals Covered364
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $2,596
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,596
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 3
Insurance contract or identification number1068797
Number of Individuals Covered147
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $3,840
Total amount of fees paid to insurance companyUSD $721
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,840
Amount paid for insurance broker fees721
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 4
Insurance contract or identification numberE4344313
Number of Individuals Covered124
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $10,764
Total amount of fees paid to insurance companyUSD $2,309
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $68,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,655
Amount paid for insurance broker fees1023
Additional information about fees paid to insurance brokerFEE
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4344313
Policy instance 4
Insurance contract or identification numberE4344313
Number of Individuals Covered167
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $23,232
Total amount of fees paid to insurance companyUSD $3,583
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL, CANCER
Welfare Benefit Premiums Paid to CarrierUSD $83,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1068797
Policy instance 3
Insurance contract or identification number1068797
Number of Individuals Covered155
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $3,703
Total amount of fees paid to insurance companyUSD $94
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number752474
Policy instance 1
Insurance contract or identification number752474
Number of Individuals Covered374
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $7,748
Total amount of fees paid to insurance companyUSD $94,958
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,088,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Vision Insurance Welfare BenefitYes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number305244
Policy instance 2
Insurance contract or identification number305244
Number of Individuals Covered346
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $2,061
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $26,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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