Insurance contract or identification number | 34209 |
Number of Individuals Covered | 53 |
Insurance policy start date | 2022-04-01 |
Insurance policy end date | 2022-12-31 |
Total amount of commissions paid to insurance broker | USD $5,348 |
Total amount of fees paid to insurance company | USD $0 |
Dental Insurance Welfare Benefit | Yes |
Life Insurance Welfare Benefit | Yes |
Temporary Disability Insurance Welfare Benefit | Yes |
Long Term Disability Insurance Welfare Benefit | Yes |
Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT |
Welfare Benefit Premiums Paid to Carrier | USD $38,821 |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
Commission paid to Insurance Broker | USD $2,988 |
Amount paid for insurance broker fees | 0 |
Insurance broker organization code? | 3 |