COX ENGINEERING COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan COX ENGINEERING COMPANY WELFARE BENEFIT PLAN
Measure | Date | Value |
---|
2022: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-06-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 262 |
Total of all active and inactive participants | 2022-06-01 | 262 |
2021: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-06-01 | 228 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 262 |
Number of retired or separated participants receiving benefits | 2021-06-01 | 1 |
Total of all active and inactive participants | 2021-06-01 | 263 |
2020: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-06-01 | 219 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 228 |
Number of retired or separated participants receiving benefits | 2020-06-01 | 1 |
Total of all active and inactive participants | 2020-06-01 | 229 |
2019: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-06-01 | 183 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 219 |
Total of all active and inactive participants | 2019-06-01 | 219 |
2018: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-06-01 | 150 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 183 |
Total of all active and inactive participants | 2018-06-01 | 183 |
2017: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-06-01 | 108 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 149 |
Number of retired or separated participants receiving benefits | 2017-06-01 | 1 |
Total of all active and inactive participants | 2017-06-01 | 150 |
Total participants | 2017-06-01 | 150 |
2016: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-06-01 | 108 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 108 |
Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
Total of all active and inactive participants | 2016-06-01 | 108 |
Total participants | 2016-06-01 | 108 |
2015: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-06-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 110 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 1 |
Total of all active and inactive participants | 2015-06-01 | 112 |
Total participants | 2015-06-01 | 112 |
2010: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2010 401k membership |
---|
Total participants, beginning-of-year | 2010-06-01 | 110 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-06-01 | 108 |
Number of retired or separated participants receiving benefits | 2010-06-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2010-06-01 | 2 |
Total of all active and inactive participants | 2010-06-01 | 113 |
Total participants | 2010-06-01 | 113 |
2009: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-06-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 105 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2009-06-01 | 0 |
Total of all active and inactive participants | 2009-06-01 | 110 |
Total participants | 2009-06-01 | 110 |
2022: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2022 form 5500 responses |
---|
2022-06-01 | Type of plan entity | Single employer plan |
2022-06-01 | Plan funding arrangement – Insurance | Yes |
2022-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-06-01 | Plan benefit arrangement – Insurance | Yes |
2022-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2021 form 5500 responses |
---|
2021-06-01 | Type of plan entity | Single employer plan |
2021-06-01 | Plan funding arrangement – Insurance | Yes |
2021-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-06-01 | Plan benefit arrangement – Insurance | Yes |
2021-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2020 form 5500 responses |
---|
2020-06-01 | Type of plan entity | Single employer plan |
2020-06-01 | Plan funding arrangement – Insurance | Yes |
2020-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-06-01 | Plan benefit arrangement – Insurance | Yes |
2020-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2019 form 5500 responses |
---|
2019-06-01 | Type of plan entity | Single employer plan |
2019-06-01 | Plan funding arrangement – Insurance | Yes |
2019-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-06-01 | Plan benefit arrangement – Insurance | Yes |
2019-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2018 form 5500 responses |
---|
2018-06-01 | Type of plan entity | Single employer plan |
2018-06-01 | Plan funding arrangement – Insurance | Yes |
2018-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-06-01 | Plan benefit arrangement – Insurance | Yes |
2018-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2017 form 5500 responses |
---|
2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | Plan funding arrangement – Insurance | Yes |
2017-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-06-01 | Plan benefit arrangement – Insurance | Yes |
2017-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2016 form 5500 responses |
---|
2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Plan funding arrangement – Insurance | Yes |
2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-06-01 | Plan benefit arrangement – Insurance | Yes |
2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2015 form 5500 responses |
---|
2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2010 form 5500 responses |
---|
2010-06-01 | Type of plan entity | Single employer plan |
2010-06-01 | Plan funding arrangement – Insurance | Yes |
2010-06-01 | Plan benefit arrangement – Insurance | Yes |
2009: COX ENGINEERING COMPANY WELFARE BENEFIT PLAN 2009 form 5500 responses |
---|
2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | Plan funding arrangement – Insurance | Yes |
2009-06-01 | Plan benefit arrangement – Insurance | Yes |
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
Policy contract number | 160408155902 |
Policy instance | 1 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 276 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $33,839 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,855,855 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,839 | Insurance broker organization code? | 3 |
|
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 ) |
Policy contract number | 160408155902 |
Policy instance | 2 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 28 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $2,987 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $137,991 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,987 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
Policy contract number | 0152040000 |
Policy instance | 3 |
Insurance contract or identification number | 0152040000 | Number of Individuals Covered | 305 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $4,827 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114,084 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,827 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 4 |
Insurance contract or identification number | 30067873 | Number of Individuals Covered | 108 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $853 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,718 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $853 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 712684 |
Policy instance | 5 |
Insurance contract or identification number | 712684 | Number of Individuals Covered | 289 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $11,526 | Total amount of fees paid to insurance company | USD $2,961 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $189,455 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,526 | Amount paid for insurance broker fees | 2961 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 712685 |
Policy instance | 6 |
Insurance contract or identification number | 712685 | Number of Individuals Covered | 43 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $4,481 | Total amount of fees paid to insurance company | USD $485 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,870 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,481 | Amount paid for insurance broker fees | 485 | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 712686 |
Policy instance | 7 |
Insurance contract or identification number | 712686 | Number of Individuals Covered | 285 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $7,026 | Total amount of fees paid to insurance company | USD $4,018 | Other welfare benefits provided | MA PFML | Welfare Benefit Premiums Paid to Carrier | USD $229,199 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,026 | Amount paid for insurance broker fees | 4018 | Insurance broker organization code? | 3 |
|
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
Policy contract number | 160408155902 |
Policy instance | 1 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 256 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $25,656 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,683,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,656 | Insurance broker organization code? | 3 |
|
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 ) |
Policy contract number | 160408155902 |
Policy instance | 2 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 18 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,871 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114,796 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,871 | Insurance broker organization code? | 3 |
|
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
Policy contract number | 0152040000 |
Policy instance | 3 |
Insurance contract or identification number | 0152040000 | Number of Individuals Covered | 282 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $4,468 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $114,084 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,468 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 4 |
Insurance contract or identification number | 30067873 | Number of Individuals Covered | 88 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,613 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,115 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,613 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878558G |
Policy instance | 5 |
Insurance contract or identification number | 878558G | Number of Individuals Covered | 249 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $11,265 | Total amount of fees paid to insurance company | USD $7,555 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,920 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,265 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 7555 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 712684 |
Policy instance | 6 |
Insurance contract or identification number | 712684 | Number of Individuals Covered | 262 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $7,802 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $56,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,802 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 712685 |
Policy instance | 7 |
Insurance contract or identification number | 712685 | Number of Individuals Covered | 42 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,740 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,061 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,740 | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 712686 |
Policy instance | 8 |
Insurance contract or identification number | 712686 | Number of Individuals Covered | 84 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $906 | Other welfare benefits provided | MA PFML | Welfare Benefit Premiums Paid to Carrier | USD $5,884 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $906 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878558G |
Policy instance | 1 |
Insurance contract or identification number | 878558G | Number of Individuals Covered | 228 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $26,599 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $156,468 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,543 | Insurance broker organization code? | 3 |
|
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 ) |
Policy contract number | 160408155902 |
Policy instance | 3 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 12 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $2,175 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $77,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,175 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 4 |
Insurance contract or identification number | 30067873 | Number of Individuals Covered | 69 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $733 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,570 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $733 |
|
TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
Policy contract number | 160408155902 |
Policy instance | 2 |
Insurance contract or identification number | 160408155902 | Number of Individuals Covered | 244 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $46,369 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,662,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $46,369 | Insurance broker organization code? | 3 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4936867 |
Policy instance | 2 |
Insurance contract or identification number | 4936867 | Number of Individuals Covered | 121 | Total amount of commissions paid to insurance broker | USD $41,829 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,829 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878558G |
Policy instance | 1 |
Insurance contract or identification number | 878558G | Number of Individuals Covered | 219 | Total amount of commissions paid to insurance broker | USD $15,158 | Total amount of fees paid to insurance company | USD $10,027 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $143,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,158 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 10027 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 3 |
Insurance contract or identification number | 30067873 | Number of Individuals Covered | 62 | Total amount of commissions paid to insurance broker | USD $644 | 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 $644 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 3 |
Insurance contract or identification number | 30067873 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $589 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,282 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $589 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878558G |
Policy instance | 2 |
Insurance contract or identification number | 878558G | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $16,592 | Total amount of fees paid to insurance company | USD $11,288 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $158,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,592 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 11288 |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4936867 |
Policy instance | 1 |
Insurance contract or identification number | 4936867 | Number of Individuals Covered | 114 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $37,284 | Health Insurance Welfare Benefit | Yes | Dental 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 $37,284 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878558G |
Policy instance | 1 |
Insurance contract or identification number | 878558G | Total amount of commissions paid to insurance broker | USD $10,643 | Total amount of fees paid to insurance company | USD $5,518 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $100,290 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,643 | Amount paid for insurance broker fees | 5518 | Insurance broker name | INDIGO INS SERVICES LLC |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4936867 |
Policy instance | 2 |
Insurance contract or identification number | 4936867 | Number of Individuals Covered | 112 | Total amount of commissions paid to insurance broker | USD $36,863 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,274,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,863 | Insurance broker name | ERIC GULKO |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30067873 |
Policy instance | 3 |
Insurance contract or identification number | 30067873 | Number of Individuals Covered | 33 | Total amount of commissions paid to insurance broker | USD $453 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $453 | Insurance broker name | ERIC GULKO |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100004219 |
Policy instance | 2 |
Insurance contract or identification number | 40000100004219 | Number of Individuals Covered | 21 | Total amount of commissions paid to insurance broker | USD $1,626 | Other welfare benefits provided | VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $10,838 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,626 | Insurance broker organization code? | 3 | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056933 |
Policy instance | 3 |
Insurance contract or identification number | 860056933 | Number of Individuals Covered | 110 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $2,116 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,384 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,116 | Insurance broker organization code? | 3 | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056932 |
Policy instance | 4 |
Insurance contract or identification number | 860056932 | Number of Individuals Covered | 110 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $3,286 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,279 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,286 | Insurance broker organization code? | 3 | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4936867 |
Policy instance | 5 |
Insurance contract or identification number | 4936867 | Number of Individuals Covered | 91 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $4,044 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,762 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,044 | Insurance broker organization code? | 3 | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056931 |
Policy instance | 1 |
Insurance contract or identification number | 860056931 | Number of Individuals Covered | 110 | Total amount of commissions paid to insurance broker | USD $2,038 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,038 | Insurance broker organization code? | 3 | Insurance broker name | SUMMIT FINANCIAL INSURANCE AGENCY |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056933 |
Policy instance | 2 |
Insurance contract or identification number | 860056933 | Number of Individuals Covered | 92 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1,971 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,715 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4936867 |
Policy instance | 1 |
Insurance contract or identification number | 4936867 | Number of Individuals Covered | 164 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $23,973 | Total amount of fees paid to insurance company | USD $1,342 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $861,139 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056931 |
Policy instance | 3 |
Insurance contract or identification number | 860056931 | Number of Individuals Covered | 107 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1,508 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,648 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) |
Policy contract number | 001020 |
Policy instance | 5 |
Insurance contract or identification number | 001020 | Number of Individuals Covered | 100 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $2,860 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $80,748 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100004219 |
Policy instance | 6 |
Insurance contract or identification number | 40000100004219 | Number of Individuals Covered | 69 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $1,367 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 860056932 |
Policy instance | 4 |
Insurance contract or identification number | 860056932 | Number of Individuals Covered | 92 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $2,241 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|