G&S HOLDINGS, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2021: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 744 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 750 |
| Total of all active and inactive participants | 2021-09-01 | 750 |
| 2020: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 717 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 744 |
| Total of all active and inactive participants | 2020-09-01 | 744 |
| 2019: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 717 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 717 |
| Total of all active and inactive participants | 2019-09-01 | 717 |
| 2018: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 688 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 717 |
| Total of all active and inactive participants | 2018-09-01 | 717 |
| 2017: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 644 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 688 |
| Total of all active and inactive participants | 2017-09-01 | 688 |
| 2016: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 637 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 644 |
| Total of all active and inactive participants | 2016-09-01 | 644 |
| 2015: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 570 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 637 |
| Total of all active and inactive participants | 2015-09-01 | 637 |
| 2014: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 571 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 570 |
| Total of all active and inactive participants | 2014-09-01 | 570 |
| 2013: G&S HOLDINGS, LLC MEDICAL BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 530 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 571 |
| Total of all active and inactive participants | 2013-09-01 | 571 |
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000027749 |
| Policy instance | 5 |
| Insurance contract or identification number | 0000027749 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $50,255 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $67,723 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,255 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497314 |
| Policy instance | 4 |
| Insurance contract or identification number | 497314 | | Number of Individuals Covered | 454 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-09-01 | | Total amount of commissions paid to insurance broker | USD $40,656 | | Total amount of fees paid to insurance company | USD $7,020 | | Welfare Benefit Premiums Paid to Carrier | USD $271,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,656 | | Amount paid for insurance broker fees | 7020 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497313 |
| Policy instance | 3 |
| Insurance contract or identification number | 497313 | | Number of Individuals Covered | 750 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-09-01 | | Total amount of commissions paid to insurance broker | USD $68,851 | | Total amount of fees paid to insurance company | USD $11,676 | | Welfare Benefit Premiums Paid to Carrier | USD $459,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $68,851 | | Amount paid for insurance broker fees | 11676 | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | 444324 |
| Policy instance | 2 |
| Insurance contract or identification number | 444324 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $8,570 | | Total amount of fees paid to insurance company | USD $1,725 | | Welfare Benefit Premiums Paid to Carrier | USD $71,380 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,570 | | Amount paid for insurance broker fees | 1725 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 576 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $97,396 | | Total amount of fees paid to insurance company | USD $988,443 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 647752 | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $97,396 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 567 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $99,059 | | Total amount of fees paid to insurance company | USD $985,355 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 660310 | | Additional information about fees paid to insurance broker | REINSURANCE PREMIUMS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $99,059 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700864 |
| Policy instance | 2 |
| Insurance contract or identification number | R0700864 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-09-01 | | Total amount of commissions paid to insurance broker | USD $21,601 | | Total amount of fees paid to insurance company | USD $2,016 | | Welfare Benefit Premiums Paid to Carrier | USD $119,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,601 | | Amount paid for insurance broker fees | 2016 | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | STRIB916 |
| Policy instance | 3 |
| Insurance contract or identification number | STRIB916 | | Number of Individuals Covered | 452 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $10,040 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $83,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,040 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497313 |
| Policy instance | 4 |
| Insurance contract or identification number | 497313 | | Number of Individuals Covered | 744 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-09-01 | | Total amount of commissions paid to insurance broker | USD $53,691 | | Total amount of fees paid to insurance company | USD $17,897 | | Welfare Benefit Premiums Paid to Carrier | USD $357,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,691 | | Amount paid for insurance broker fees | 17897 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497314 |
| Policy instance | 5 |
| Insurance contract or identification number | 497314 | | Number of Individuals Covered | 443 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-09-01 | | Total amount of commissions paid to insurance broker | USD $37,819 | | Total amount of fees paid to insurance company | USD $12,540 | | Welfare Benefit Premiums Paid to Carrier | USD $250,790 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,819 | | Amount paid for insurance broker fees | 12540 | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0011592340 |
| Policy instance | 6 |
| Insurance contract or identification number | 0011592340 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-09-01 | | Total amount of commissions paid to insurance broker | USD $6,138 | | Total amount of fees paid to insurance company | USD $560 | | Welfare Benefit Premiums Paid to Carrier | USD $19,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,138 | | Amount paid for insurance broker fees | 560 | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | STRIB916 |
| Policy instance | 8 |
| Insurance contract or identification number | STRIB916 | | Number of Individuals Covered | 407 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $8,785 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $73,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,785 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 7 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-01 | | Total amount of commissions paid to insurance broker | USD $2,260 | | Total amount of fees paid to insurance company | USD $1,407 | | Welfare Benefit Premiums Paid to Carrier | USD $22,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,260 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1407 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 6 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 351 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $57,482 | | Total amount of fees paid to insurance company | USD $13,223 | | Welfare Benefit Premiums Paid to Carrier | USD $209,024 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,482 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 13223 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 5 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 448 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $16,472 | | Total amount of fees paid to insurance company | USD $6,900 | | Welfare Benefit Premiums Paid to Carrier | USD $109,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,472 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6900 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 4 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 538 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $13,015 | | Total amount of fees paid to insurance company | USD $5,809 | | Welfare Benefit Premiums Paid to Carrier | USD $86,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,015 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5809 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 3 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 717 | | 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 $14,646 | | Welfare Benefit Premiums Paid to Carrier | USD $227,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 14646 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700864 |
| Policy instance | 2 |
| Insurance contract or identification number | R0700864 | | Number of Individuals Covered | 595 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $25,657 | | Total amount of fees paid to insurance company | USD $2,454 | | Welfare Benefit Premiums Paid to Carrier | USD $110,338 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,657 | | Amount paid for insurance broker fees | 2454 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 540 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $98,443 | | Total amount of fees paid to insurance company | USD $978,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 655077 | | Additional information about fees paid to insurance broker | REINSURANCE PREMIUMS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $98,443 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 548 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $89,524 | | Total amount of fees paid to insurance company | USD $922,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 595922 | | Additional information about fees paid to insurance broker | REINSURANCE PREMIUMS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $89,524 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700864 |
| Policy instance | 2 |
| Insurance contract or identification number | R0700864 | | Number of Individuals Covered | 445 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $23,570 | | Total amount of fees paid to insurance company | USD $2,478 | | Welfare Benefit Premiums Paid to Carrier | USD $89,306 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,570 | | Amount paid for insurance broker fees | 2478 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 4 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $11,916 | | Total amount of fees paid to insurance company | USD $5,201 | | Welfare Benefit Premiums Paid to Carrier | USD $79,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,916 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5201 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 3 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 717 | | 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 $13,394 | | Welfare Benefit Premiums Paid to Carrier | USD $203,566 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 13394 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 5 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 434 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $14,463 | | Total amount of fees paid to insurance company | USD $6,416 | | Welfare Benefit Premiums Paid to Carrier | USD $96,419 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,463 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6416 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 6 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $55,345 | | Total amount of fees paid to insurance company | USD $14,942 | | Welfare Benefit Premiums Paid to Carrier | USD $201,256 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,345 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 14942 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 7 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-01 | | Total amount of commissions paid to insurance broker | USD $1,734 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $17,336 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,734 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | STRIB916 |
| Policy instance | 8 |
| Insurance contract or identification number | STRIB916 | | Number of Individuals Covered | 385 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $8,234 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $68,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,234 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 235694 |
| Policy instance | 2 |
| Insurance contract or identification number | 235694 | | Number of Individuals Covered | 639 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $17,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 4 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 513 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $10,829 | | Total amount of fees paid to insurance company | USD $4,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0700864 |
| Policy instance | 3 |
| Insurance contract or identification number | R0700864 | | Number of Individuals Covered | 377 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $48,098 | | Total amount of fees paid to insurance company | USD $6,142 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 5 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 402 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $13,154 | | Total amount of fees paid to insurance company | USD $5,695 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 6 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 688 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $12,361 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000B7B6 |
| Policy instance | 7 |
| Insurance contract or identification number | G000B7B6 | | Number of Individuals Covered | 352 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $53,430 | | Total amount of fees paid to insurance company | USD $14,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 204085 |
| Policy instance | 8 |
| Insurance contract or identification number | 204085 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $602 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | VARIOUS |
| Policy instance | 1 |
| Insurance contract or identification number | VARIOUS | | Number of Individuals Covered | 518 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $84,770 | | Total amount of fees paid to insurance company | USD $883,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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