PALMETTO SYNTHETICS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC
401k plan membership statisitcs for GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC
| Measure | Date | Value |
|---|
| 2022: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 171 |
| Total of all active and inactive participants | 2022-01-01 | 171 |
| 2021: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 179 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 174 |
| Total of all active and inactive participants | 2021-01-01 | 174 |
| 2020: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 191 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 179 |
| Total of all active and inactive participants | 2020-01-01 | 179 |
| 2019: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 191 |
| Total of all active and inactive participants | 2019-01-01 | 191 |
| 2018: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 225 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 212 |
| Total of all active and inactive participants | 2018-01-01 | 212 |
| 2017: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 225 |
| Total of all active and inactive participants | 2017-01-01 | 225 |
| 2016: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 231 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 199 |
| Total of all active and inactive participants | 2016-01-01 | 199 |
| 2015: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 233 |
| Total of all active and inactive participants | 2015-01-01 | 233 |
| 2014: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 203 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 232 |
| Total of all active and inactive participants | 2014-01-01 | 232 |
| 2013: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 203 |
| Total of all active and inactive participants | 2013-01-01 | 203 |
| 2012: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 156 |
| Total of all active and inactive participants | 2012-01-01 | 156 |
| 2011: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 140 |
| Total of all active and inactive participants | 2011-01-01 | 140 |
| 2010: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 125 |
| Total of all active and inactive participants | 2010-01-01 | 125 |
| 2009: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 122 |
| Total of all active and inactive participants | 2009-01-01 | 122 |
| 2022: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP INSURANCE PLAN FOR EMPLOYEES OF PALMETTO SYNTHETICS, LLC 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00502432 |
| Policy instance | 2 |
| Insurance contract or identification number | 00502432 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $39,190 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $39,190 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 66-17568 |
| Policy instance | 1 |
| Insurance contract or identification number | 66-17568 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $84,935 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 84935 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00502432 |
| Policy instance | 2 |
| Insurance contract or identification number | 00502432 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $36,199 | | Total amount of fees paid to insurance company | USD $1 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $36,199 | | Amount paid for insurance broker fees | 1 | | Insurance broker organization code? | 3 |
|
| INTERNATIONAL INSURANCE AGENCY (National Association of Insurance Commissioners NAIC id number: 86355 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 149 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $55,800 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 55800 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00502432 |
| Policy instance | 2 |
| Insurance contract or identification number | 00502432 | | Number of Individuals Covered | 179 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | Total amount of commissions paid to insurance broker | USD $36,727 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $36,727 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85474 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-85474 | | Number of Individuals Covered | 161 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $55,543 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 55543 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00502432 |
| Policy instance | 2 |
| Insurance contract or identification number | 00502432 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | Total amount of commissions paid to insurance broker | USD $39,598 | | Total amount of fees paid to insurance company | USD $9,236 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $39,598 | | Amount paid for insurance broker fees | 9236 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85474 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-85474 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $51,719 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 51719 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00502432 |
| Policy instance | 3 |
| Insurance contract or identification number | 00502432 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2016-08-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $28,510 | | Total amount of fees paid to insurance company | USD $8,043 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $28,510 | | Amount paid for insurance broker fees | 8043 | | Insurance broker name | |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | |
| Policy instance | 2 |
| Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $1,886 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,886 | | Insurance broker name | MCA ADMINISTRATORS |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | |
| Policy instance | 1 |
| Number of Individuals Covered | 225 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $44,850 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 37375 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Insurance broker name | HEALTHCARE CHOICE |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | |
| Policy instance | 2 |
| Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,455 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,455 | | Insurance broker name | MCA ADMINISTRATORS |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 25-85002-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-85002-00 | | Number of Individuals Covered | 233 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $82,950 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 69125 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Insurance broker name | HEALTHCARE CHOICE |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | |
| Policy instance | 2 |
| Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $3,419 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,419 | | Insurance broker name | MCA ADMINISTRATORS |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | 25-85002-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-85002-00 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-07-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $81,450 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 81450 | | Additional information about fees paid to insurance broker | BROKER FEES | | Insurance broker organization code? | 3 | | Insurance broker name | MONTGOMERY MANAGEMENT |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-85002-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-85002-00 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-08-01 | | Total amount of commissions paid to insurance broker | USD $52,141 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $52,141 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| MEDICAL MUTUAL (National Association of Insurance Commissioners NAIC id number: 95732 ) |
| Policy contract number | |
| Policy instance | 1 |
| Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $41,559 | | Total amount of fees paid to insurance company | USD $5,011 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,559 | | Amount paid for insurance broker fees | 5000 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | GIBSON & ASSOCIATES, INC. |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-98762 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-98762 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-08-01 | | Total amount of commissions paid to insurance broker | USD $19,882 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 ) |
| Policy contract number | 25-98762 |
| Policy instance | 1 |
| Insurance contract or identification number | 25-98762 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $43,303 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,303 | | Additional information about fees paid to insurance broker | BROKER COMMISSIONS | | Insurance broker organization code? | 3 | | Insurance broker name | GIBSON & ASSOCIATES, INC. |
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