TRO JUNG/BRANNEN CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TRO CORPORATION EMPLOYEE BENEFIT PLAN
Measure | Date | Value |
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2017: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-06-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 0 |
Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
Total of all active and inactive participants | 2017-06-01 | 0 |
2016: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 115 |
Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
Total of all active and inactive participants | 2016-06-01 | 115 |
2015: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 117 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
Total of all active and inactive participants | 2015-06-01 | 117 |
2014: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 109 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 116 |
Number of retired or separated participants receiving benefits | 2014-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
Total of all active and inactive participants | 2014-06-01 | 116 |
2013: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 131 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 109 |
Number of retired or separated participants receiving benefits | 2013-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
Total of all active and inactive participants | 2013-06-01 | 109 |
2012: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 131 |
Number of retired or separated participants receiving benefits | 2012-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-06-01 | 0 |
Total of all active and inactive participants | 2012-06-01 | 131 |
2011: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 135 |
Number of retired or separated participants receiving benefits | 2011-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-06-01 | 0 |
Total of all active and inactive participants | 2011-06-01 | 135 |
2009: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 191 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 179 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 26 |
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 | 205 |
2017: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
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2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | This submission is the final filing | Yes |
2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
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: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2016 form 5500 responses |
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2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Submission has been amended | No |
2016-06-01 | This submission is the final filing | No |
2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-06-01 | Plan is a collectively bargained plan | No |
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: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2015 form 5500 responses |
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2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Submission has been amended | No |
2015-06-01 | This submission is the final filing | No |
2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-06-01 | Plan is a collectively bargained plan | No |
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 |
2014: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2014 form 5500 responses |
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2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Submission has been amended | No |
2014-06-01 | This submission is the final filing | No |
2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-06-01 | Plan is a collectively bargained plan | No |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2013 form 5500 responses |
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2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Submission has been amended | No |
2013-06-01 | This submission is the final filing | No |
2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-06-01 | Plan is a collectively bargained plan | No |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2012 form 5500 responses |
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2012-06-01 | Type of plan entity | Single employer plan |
2012-06-01 | Submission has been amended | No |
2012-06-01 | This submission is the final filing | No |
2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-06-01 | Plan is a collectively bargained plan | No |
2012-06-01 | Plan funding arrangement – Insurance | Yes |
2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-06-01 | Plan benefit arrangement – Insurance | Yes |
2012-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2011 form 5500 responses |
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2011-06-01 | Type of plan entity | Single employer plan |
2011-06-01 | Submission has been amended | No |
2011-06-01 | This submission is the final filing | No |
2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-06-01 | Plan is a collectively bargained plan | No |
2011-06-01 | Plan funding arrangement – Insurance | Yes |
2011-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-06-01 | Plan benefit arrangement – Insurance | Yes |
2011-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: TRO CORPORATION EMPLOYEE BENEFIT PLAN 2009 form 5500 responses |
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2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | Submission has been amended | No |
2009-06-01 | This submission is the final filing | No |
2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-06-01 | Plan is a collectively bargained plan | No |
2009-06-01 | Plan funding arrangement – Insurance | Yes |
2009-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-06-01 | Plan benefit arrangement – Insurance | Yes |
2009-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD126214 |
Policy instance | 5 |
Insurance contract or identification number | LTD126214 | Number of Individuals Covered | 95 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,681 | Total amount of fees paid to insurance company | USD $852 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $17,876 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,681 | Amount paid for insurance broker fees | 852 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT INSURANCE SERVICE |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 96962791001 |
Policy instance | 4 |
Insurance contract or identification number | 96962791001 | Number of Individuals Covered | 73 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $291 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,945 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $291 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL654909 |
Policy instance | 3 |
Insurance contract or identification number | ABL654909 | Number of Individuals Covered | 95 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $180 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $180 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | POOLE PROFESSIONAL LTD |
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COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 00 |
Policy instance | 2 |
Insurance contract or identification number | 00 | Number of Individuals Covered | 1 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $2,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 239 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $18,811 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $655,972 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $18,811 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | UNKNOWN |
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COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | EAP |
Policy instance | 2 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 117 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 3 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 75 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $506 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,151 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $506 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL154130 |
Policy instance | 4 |
Insurance contract or identification number | GL154130 | Number of Individuals Covered | 127 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $4,997 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $33,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,997 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL654909 |
Policy instance | 5 |
Insurance contract or identification number | ABL654909 | Number of Individuals Covered | 117 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $180 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,200 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $180 | Insurance broker organization code? | 3 | Insurance broker name | POOLE PROFESSIONAL LTD |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 236 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $29,969 | Total amount of fees paid to insurance company | USD $8,755 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,282,869 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $29,969 | Amount paid for insurance broker fees | 8755 | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | ABL654909 |
Policy instance | 5 |
Insurance contract or identification number | ABL654909 | Number of Individuals Covered | 116 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $193 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,285 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $193 | Insurance broker organization code? | 3 | Insurance broker name | POOLE PROFESSIONAL LTD |
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ESI (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | 2999 |
Policy instance | 4 |
Insurance contract or identification number | 2999 | Number of Individuals Covered | 113 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139004 |
Policy instance | 3 |
Insurance contract or identification number | 139004 | Number of Individuals Covered | 116 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $4,880 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,880 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 2 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 68 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $471 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,093 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $471 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 237 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $29,429 | Total amount of fees paid to insurance company | USD $4,850 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,225,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $29,429 | Amount paid for insurance broker fees | 4850 | Additional information about fees paid to insurance broker | OTHER COMMISSION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 206 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $26,079 | Total amount of fees paid to insurance company | USD $7,905 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $982,683 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $26,079 | Amount paid for insurance broker fees | 7905 | Additional information about fees paid to insurance broker | OTHER COMMISSION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139004 |
Policy instance | 3 |
Insurance contract or identification number | 139004 | Number of Individuals Covered | 109 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $5,239 | Total amount of fees paid to insurance company | USD $681 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,239 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 681 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 2 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 75 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $586 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,860 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $586 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139004 |
Policy instance | 3 |
Insurance contract or identification number | 139004 | Number of Individuals Covered | 126 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $5,693 | Total amount of fees paid to insurance company | USD $761 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,693 | Amount paid for insurance broker fees | 761 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 2 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 88 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $651 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $6,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $651 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 212 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $29,012 | Total amount of fees paid to insurance company | USD $8,840 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,199,919 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $29,012 | Amount paid for insurance broker fees | 8840 | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 2 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 0 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $748 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $6,957 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139004 |
Policy instance | 3 |
Insurance contract or identification number | 139004 | Number of Individuals Covered | 135 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $6,528 | Total amount of fees paid to insurance company | USD $873 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 285 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $34,716 | Total amount of fees paid to insurance company | USD $12,665 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9696279 |
Policy instance | 2 |
Insurance contract or identification number | 9696279 | Number of Individuals Covered | 90 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $771 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $7,690 |
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
Policy contract number | 4939447 |
Policy instance | 1 |
Insurance contract or identification number | 4939447 | Number of Individuals Covered | 348 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $38,340 | Total amount of fees paid to insurance company | USD $14,875 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 139004 |
Policy instance | 3 |
Insurance contract or identification number | 139004 | Number of Individuals Covered | 174 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $6,961 | Total amount of fees paid to insurance company | USD $1,115 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No |
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