GREAT SOUTHERN BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN
401k plan membership statisitcs for GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN
Measure | Date | Value |
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2022: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 212 |
Total of all active and inactive participants | 2022-01-01 | 212 |
Total participants | 2022-01-01 | 212 |
2021: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 195 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 195 |
Total of all active and inactive participants | 2021-01-01 | 195 |
Total participants | 2021-01-01 | 195 |
2020: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 195 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 195 |
Total participants | 2020-01-01 | 195 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-01-01 | 0 |
Number of participants with account balances | 2020-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-01-01 | 0 |
2019: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 131 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 127 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 127 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
Total participants | 2019-01-01 | 127 |
Number of participants with account balances | 2019-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
2018: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 135 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 131 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 131 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
Total participants | 2018-01-01 | 131 |
Number of participants with account balances | 2018-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
2017: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 138 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 135 |
Total of all active and inactive participants | 2017-01-01 | 135 |
Total participants | 2017-01-01 | 135 |
2016: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 138 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 138 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
Total participants | 2016-01-01 | 138 |
Number of participants with account balances | 2016-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2016-01-01 | 0 |
2015: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 148 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 146 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 146 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
Total participants | 2015-01-01 | 146 |
Number of participants with account balances | 2015-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2015-01-01 | 0 |
2014: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 144 |
Total of all active and inactive participants | 2014-01-01 | 0 |
Total participants | 2014-01-01 | 0 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 148 |
2013: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 144 |
Total of all active and inactive participants | 2013-01-01 | 144 |
Total participants | 2013-01-01 | 144 |
2012: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 143 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 141 |
Total of all active and inactive participants | 2012-01-01 | 141 |
Total participants | 2012-01-01 | 141 |
2011: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 150 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 143 |
Total of all active and inactive participants | 2011-01-01 | 143 |
Total participants | 2011-01-01 | 143 |
2009: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 140 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 147 |
Total of all active and inactive participants | 2009-01-01 | 147 |
Total participants | 2009-01-01 | 147 |
2022: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2022 form 5500 responses |
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
2021: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2021 form 5500 responses |
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2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2020 form 5500 responses |
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2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | Yes |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2019 form 5500 responses |
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2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | Yes |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2018 form 5500 responses |
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2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2017 form 5500 responses |
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2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2016 form 5500 responses |
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2015 form 5500 responses |
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2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2014 form 5500 responses |
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2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | Yes |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2013 form 5500 responses |
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2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2012 form 5500 responses |
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2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
2011: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2011 form 5500 responses |
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2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Plan funding arrangement – Insurance | Yes |
2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-01-01 | Plan benefit arrangement – Insurance | Yes |
2009: GREAT SOUTHERN BANK LIFE INSURANCE & DISABILITY PLAN 2009 form 5500 responses |
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2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | Yes |
2009-01-01 | Plan funding arrangement – Insurance | Yes |
2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-01-01 | Plan benefit arrangement – Insurance | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5967522 |
Policy instance | 1 |
Insurance contract or identification number | 5967522 | Number of Individuals Covered | 212 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $3,743 | Total amount of fees paid to insurance company | USD $776 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,850 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,743 | Amount paid for insurance broker fees | 776 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5967522 |
Policy instance | 1 |
Insurance contract or identification number | 5967522 | Number of Individuals Covered | 195 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $3,606 | Total amount of fees paid to insurance company | USD $1,080 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,136 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,606 | Amount paid for insurance broker fees | 1080 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5967522 |
Policy instance | 1 |
Insurance contract or identification number | 5967522 | Number of Individuals Covered | 195 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $2,855 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $24,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,855 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 127 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $5,613 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $31,312 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,613 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 131 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $5,187 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,726 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,187 | Insurance broker organization code? | 3 |
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DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 18513 |
Policy instance | 2 |
Insurance contract or identification number | 18513 | Number of Individuals Covered | 105 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $7,812 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $47,340 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,812 | Insurance broker organization code? | 3 |
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DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 ) |
Policy contract number | 18513 |
Policy instance | 2 |
Insurance contract or identification number | 18513 | Number of Individuals Covered | 104 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $8,116 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $49,181 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,116 | Insurance broker organization code? | 3 | Insurance broker name | MWG ADMINISTRATORS |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 135 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $5,382 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $29,998 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,382 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 142 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $5,100 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,181 | Commission paid to Insurance Broker | USD $5,100 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05996875 |
Policy instance | 2 |
Insurance contract or identification number | TM05996875 | Number of Individuals Covered | 146 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $4,178 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,225 | Commission paid to Insurance Broker | USD $4,178 | Insurance broker organization code? | 3 | Insurance broker name | STOCKETT & THOMAS AGENCY, LLP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Number of Individuals Covered | 135 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $5,198 | Welfare Benefit Premiums Paid to Carrier | USD $28,720 | Commission paid to Insurance Broker | USD $5,198 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05996875 |
Policy instance | 2 |
Insurance contract or identification number | TM05996875 | Dental Insurance Welfare Benefit | Yes | Number of Individuals Covered | 148 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $3,856 | Welfare Benefit Premiums Paid to Carrier | USD $38,706 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,856 | Insurance broker organization code? | 3 | Insurance broker name | STOCKETT & THOMAS AGENCY, LLP |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05996875 |
Policy instance | 2 |
Insurance contract or identification number | TM05996875 | Number of Individuals Covered | 144 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $3,274 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,767 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,274 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | STOCKETT & THOMAS AGENCY, LLP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 1 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 139 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $5,107 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,217 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,107 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
Policy contract number | 43184 & 43185 |
Policy instance | 1 |
Insurance contract or identification number | 43184 & 43185 | Number of Individuals Covered | 141 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $28,288 | 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 $28,288 | Insurance broker organization code? | 3 | Insurance broker name | ROBERT SANFORD |
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AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 ) |
Policy contract number | PREMIUM SAVER |
Policy instance | 2 |
Insurance contract or identification number | PREMIUM SAVER | Number of Individuals Covered | 141 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $20,361 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,387 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,787 | Insurance broker organization code? | 3 | Insurance broker name | ROBERT SANFORD |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 3 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 141 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,097 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,162 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,097 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 221816 |
Policy instance | 4 |
Insurance contract or identification number | 221816 | Number of Individuals Covered | 141 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,665 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,423 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,665 | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010075708 |
Policy instance | 1 |
Insurance contract or identification number | 000010075708 | Number of Individuals Covered | 162 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,000 | Total amount of fees paid to insurance company | USD $891 | 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 $19,992 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
Policy contract number | 43184 & 43185 |
Policy instance | 2 |
Insurance contract or identification number | 43184 & 43185 | Number of Individuals Covered | 141 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $28,114 | Total amount of fees paid to insurance company | USD $28,114 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010075709 |
Policy instance | 3 |
Insurance contract or identification number | 000010075709 | Number of Individuals Covered | 143 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,449 | Total amount of fees paid to insurance company | USD $1,015 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,992 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 ) |
Policy contract number | L97-500 |
Policy instance | 4 |
Insurance contract or identification number | L97-500 | Number of Individuals Covered | 107 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $27,145 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $180,969 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00400099493 |
Policy instance | 5 |
Insurance contract or identification number | 00400099493 | Number of Individuals Covered | 71 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,690 | Total amount of fees paid to insurance company | USD $505 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,266 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010075708 |
Policy instance | 1 |
Insurance contract or identification number | 000010075708 | Number of Individuals Covered | 168 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $990 | Total amount of fees paid to insurance company | USD $868 | Health Insurance Welfare Benefit | Yes | 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 $19,808 | Commission paid to Insurance Broker | USD $990 | Amount paid for insurance broker fees | 868 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
Policy contract number | 43184 |
Policy instance | 2 |
Insurance contract or identification number | 43184 | Number of Individuals Covered | 150 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $28,223 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Commission paid to Insurance Broker | USD $28,223 | Insurance broker organization code? | 3 | Insurance broker name | ROBERT SANFORD |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010075709 |
Policy instance | 3 |
Insurance contract or identification number | 000010075709 | Number of Individuals Covered | 146 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,385 | Total amount of fees paid to insurance company | USD $985 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,564 | Commission paid to Insurance Broker | USD $3,385 | Amount paid for insurance broker fees | 985 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 ) |
Policy contract number | L97-500 |
Policy instance | 4 |
Insurance contract or identification number | L97-500 | Number of Individuals Covered | 108 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $29,649 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $175,378 | Commission paid to Insurance Broker | USD $29,649 | Insurance broker organization code? | 3 | Insurance broker name | MORGAN WHITE LTD |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00400099493 |
Policy instance | 5 |
Insurance contract or identification number | 00400099493 | Number of Individuals Covered | 74 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,682 | Total amount of fees paid to insurance company | USD $512 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $11,211 | Commission paid to Insurance Broker | USD $1,682 | Amount paid for insurance broker fees | 512 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | BENEFITS MANAGEMENT GROUP |
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