SHAW BROTHERS CONSTRUCTION, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN
401k plan membership statisitcs for SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-05-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 111 |
| Total of all active and inactive participants | 2022-05-01 | 111 |
| 2021: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-05-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 124 |
| Total of all active and inactive participants | 2021-05-01 | 124 |
| 2020: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-05-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 161 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 3 |
| Total of all active and inactive participants | 2020-05-01 | 165 |
| 2019: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-05-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 161 |
| Number of retired or separated participants receiving benefits | 2019-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 6 |
| Total of all active and inactive participants | 2019-05-01 | 167 |
| Total participants, beginning-of-year | 2019-04-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 142 |
| Number of retired or separated participants receiving benefits | 2019-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2019-04-01 | 6 |
| Total of all active and inactive participants | 2019-04-01 | 149 |
| 2018: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 145 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2018-04-01 | 3 |
| Total of all active and inactive participants | 2018-04-01 | 149 |
| 2017: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 127 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 127 |
| 2016: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 131 |
| Number of retired or separated participants receiving benefits | 2016-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-04-01 | 2 |
| Total of all active and inactive participants | 2016-04-01 | 134 |
| 2015: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 131 |
| Total of all active and inactive participants | 2015-04-01 | 131 |
| 2014: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 113 |
| Total of all active and inactive participants | 2014-04-01 | 113 |
| 2013: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 109 |
| Total of all active and inactive participants | 2013-04-01 | 109 |
| 2012: SHAW BROTHERS CONSTRUCTION, INC. EMPLOYEE WELFARE BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 105 |
| Total of all active and inactive participants | 2012-04-01 | 105 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95517 ) |
| Policy contract number | 0149544HNO |
| Policy instance | 4 |
| Insurance contract or identification number | 0149544HNO | | Number of Individuals Covered | 146 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $93,797 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,057,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $93,797 | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007517 |
| Policy instance | 3 |
| Insurance contract or identification number | 007517 | | Number of Individuals Covered | 66 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $3,264 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,264 | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007256 |
| Policy instance | 2 |
| Insurance contract or identification number | 007256 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $8,298 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,763 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,298 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0149544 |
| Policy instance | 1 |
| Insurance contract or identification number | 0149544 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $35,384 | | Total amount of fees paid to insurance company | USD $2,240 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $463,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $35,384 | | Amount paid for insurance broker fees | 2240 | | Additional information about fees paid to insurance broker | MEDICAL RETENTION INCENTIVE RISK | | Insurance broker organization code? | 3 |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | L02691 |
| Policy instance | 5 |
| Insurance contract or identification number | L02691 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2022-05-01 | | Insurance policy end date | 2023-04-30 | | Total amount of commissions paid to insurance broker | USD $2,902 | | Total amount of fees paid to insurance company | USD $824 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,902 | | Amount paid for insurance broker fees | 824 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95517 ) |
| Policy contract number | 0149544HNO |
| Policy instance | 4 |
| Insurance contract or identification number | 0149544HNO | | Number of Individuals Covered | 142 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $890,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007256 |
| Policy instance | 2 |
| Insurance contract or identification number | 007256 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $8,169 | | Total amount of fees paid to insurance company | USD $3,268 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $99,055 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,169 | | Amount paid for insurance broker fees | 3268 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007517 |
| Policy instance | 3 |
| Insurance contract or identification number | 007517 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $3,360 | | Total amount of fees paid to insurance company | USD $812 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,360 | | Amount paid for insurance broker fees | 812 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | L02691 |
| Policy instance | 5 |
| Insurance contract or identification number | L02691 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $2,764 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,764 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0149544 |
| Policy instance | 1 |
| Insurance contract or identification number | 0149544 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2021-05-01 | | Insurance policy end date | 2022-04-30 | | Total amount of commissions paid to insurance broker | USD $201 | | Total amount of fees paid to insurance company | USD $3,675 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $626,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3675 | | Additional information about fees paid to insurance broker | MEDICAL RETENTION INCENTIVE RISK | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $201 |
|
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95517 ) |
| Policy contract number | 0149544HNO |
| Policy instance | 4 |
| Insurance contract or identification number | 0149544HNO | | Number of Individuals Covered | 260 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $1,476,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0149544 |
| Policy instance | 1 |
| Insurance contract or identification number | 0149544 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $4,136 | | Total amount of fees paid to insurance company | USD $3,100 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $292,181 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,136 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3100 | | Additional information about fees paid to insurance broker | 2020 Q4 SIGNATURE MEDICAL NEW BUSINESS INCENTIVE RISK |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007256 |
| Policy instance | 2 |
| Insurance contract or identification number | 007256 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $8,415 | | Total amount of fees paid to insurance company | USD $4,497 | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,415 | | Amount paid for insurance broker fees | 4497 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 007517 |
| Policy instance | 3 |
| Insurance contract or identification number | 007517 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2020-05-01 | | Insurance policy end date | 2021-04-30 | | Total amount of commissions paid to insurance broker | USD $3,306 | | Total amount of fees paid to insurance company | USD $1,045 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,306 | | Amount paid for insurance broker fees | 1045 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00561219 |
| Policy instance | 6 |
| Insurance contract or identification number | 00561219 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $1,255 | | Total amount of fees paid to insurance company | USD $394 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,120 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $812 | | Amount paid for insurance broker fees | 394 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 757793 |
| Policy instance | 5 |
| Insurance contract or identification number | 757793 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $3,093 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Vision 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 $3,093 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 074692 |
| Policy instance | 4 |
| Insurance contract or identification number | 074692 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $7,997 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $605,083 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,997 | | Insurance broker organization code? | 3 |
|
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
| Policy contract number | 074691 |
| Policy instance | 3 |
| Insurance contract or identification number | 074691 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $2,529 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $195,716 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,529 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 074690 |
| Policy instance | 2 |
| Insurance contract or identification number | 074690 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $8,111 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $622,472 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,111 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2019-05-01 | | Insurance policy end date | 2020-04-30 | | Total amount of commissions paid to insurance broker | USD $11,069 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $121,025 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,037 | | Insurance broker organization code? | 3 |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 00B938 |
| Policy instance | 4 |
| Insurance contract or identification number | 00B938 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $518 | | Total amount of fees paid to insurance company | USD $194 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $394 | | Amount paid for insurance broker fees | 194 | | Insurance broker organization code? | 3 |
|
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) |
| Policy contract number | 074691 |
| Policy instance | 5 |
| Insurance contract or identification number | 074691 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $5,677 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $164,206 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,677 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 074692 |
| Policy instance | 6 |
| Insurance contract or identification number | 074692 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $13,302 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $390,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,302 | | Insurance broker organization code? | 3 |
|
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) |
| Policy contract number | 074690 |
| Policy instance | 3 |
| Insurance contract or identification number | 074690 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $19,205 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $550,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,205 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $10,269 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $100,873 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,269 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
| Policy contract number | 000062165 |
| Policy instance | 2 |
| Insurance contract or identification number | 000062165 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $4,920 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,923 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 773018 |
| Policy instance | 3 |
| Insurance contract or identification number | 773018 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $2,395 | | Total amount of fees paid to insurance company | USD $154 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,395 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 91 |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 00B938 |
| Policy instance | 4 |
| Insurance contract or identification number | 00B938 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $56 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $547 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
| Policy contract number | 000062165 |
| Policy instance | 2 |
| Insurance contract or identification number | 000062165 | | Number of Individuals Covered | 275 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $432 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $365 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $556 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $7,360 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $556 | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $9,674 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $89,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,674 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
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| DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 ) |
| Policy contract number | 000062165 |
| Policy instance | 2 |
| Insurance contract or identification number | 000062165 | | Number of Individuals Covered | 282 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $4,122 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,655 | | Insurance broker organization code? | 3 | | Insurance broker name | COMBINED SERVICES LLC DBA CSONE BEN |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 773018 |
| Policy instance | 3 |
| Insurance contract or identification number | 773018 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $22,101 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,092,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,709 | | Insurance broker organization code? | 3 | | Insurance broker name | BUSINESS INSURANCE AGENCY INC |
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| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 00B938 |
| Policy instance | 4 |
| Insurance contract or identification number | 00B938 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $679 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,793 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $451 | | Insurance broker organization code? | 3 | | Insurance broker name | CROSS BENEFIT SOLUTIONS |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 00001D032228 |
| Policy instance | 5 |
| Insurance contract or identification number | 00001D032228 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2017-05-31 | | Total amount of commissions paid to insurance broker | USD $-3 | | Total amount of fees paid to insurance company | USD $1,258 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-27 | | 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 | | Amount paid for insurance broker fees | 1258 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $9,067 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $83,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,067 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 049504 |
| Policy instance | 2 |
| Insurance contract or identification number | 049504 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $3,094 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,094 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| MAINE WELLNESS ASSOCIATION CAPTIVE, LLC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16043 |
| Policy instance | 3 |
| Insurance contract or identification number | 16043 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2015-04-01 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $642,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 773018 |
| Policy instance | 4 |
| Insurance contract or identification number | 773018 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $6,428 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $272,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,428 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 00B938 |
| Policy instance | 5 |
| Insurance contract or identification number | 00B938 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $583 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $583 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| MAINE WELLNESS ASSOCIATION CAPTIVE, LLC (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 10643 |
| Policy instance | 3 |
| Insurance contract or identification number | 10643 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $5,404 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $807,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,404 | | Insurance broker organization code? | 3 | | Insurance broker name | ALLUMBAUGH AGENCY |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 049504 |
| Policy instance | 2 |
| Insurance contract or identification number | 049504 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $3,015 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,572 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,015 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 0847348 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $9,056 | | Total amount of fees paid to insurance company | USD $197 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $76,158 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,056 | | Amount paid for insurance broker fees | 197 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| MAINE WELLNESS ASSOCIATION CAPTIVE, LLC (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 10643 |
| Policy instance | 3 |
| Insurance contract or identification number | 10643 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $838,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | MAINE WELLNESS ASSOCIATION CAPTIVE |
|
| ANTHEM HEALTH PLANS OF MAINE, INC. (National Association of Insurance Commissioners NAIC id number: 52618 ) |
| Policy contract number | 049504 |
| Policy instance | 2 |
| Insurance contract or identification number | 049504 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $2,989 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,989 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 847348 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $8,475 | | 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 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $73,343 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,475 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 847348 |
| Policy instance | 1 |
| Insurance contract or identification number | 847348 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $6,911 | | 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 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $66,271 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,911 | | Insurance broker organization code? | 3 | | Insurance broker name | HOLDEN AGENCY |
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