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SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 401k Plan overview

Plan NameSUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN
Plan identification number 502

SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

SUBARU OF NEW ENGLAND, INC. has sponsored the creation of one or more 401k plans.

Company Name:SUBARU OF NEW ENGLAND, INC.
Employer identification number (EIN):042475654
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01ROBERT WEISS ROBERT WEISS2019-06-13
5022017-01-01ROBERT WEISS ROBERT WEISS2018-07-24
5022016-01-01ROBERT A. WAKELY ROBERT A. WAKELY2017-07-14
5022015-01-01ROBERT A. WAKELY ROBERT A. WAKELY2016-08-03

Plan Statistics for SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN

401k plan membership statisitcs for SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN

Measure Date Value
2022: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01150
Total number of active participants reported on line 7a of the Form 55002022-01-01149
Total of all active and inactive participants2022-01-01149
2021: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01153
Total number of active participants reported on line 7a of the Form 55002021-01-01150
Total of all active and inactive participants2021-01-01150
2020: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01157
Total number of active participants reported on line 7a of the Form 55002020-01-01153
Total of all active and inactive participants2020-01-01153
2019: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01146
Total number of active participants reported on line 7a of the Form 55002019-01-01157
Total of all active and inactive participants2019-01-01157
2018: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01148
Total number of active participants reported on line 7a of the Form 55002018-01-01146
Total of all active and inactive participants2018-01-01146
2017: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01143
Total number of active participants reported on line 7a of the Form 55002017-01-01148
Total of all active and inactive participants2017-01-01148
2016: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01131
Total number of active participants reported on line 7a of the Form 55002016-01-01143
Total of all active and inactive participants2016-01-01143
2015: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01114
Total number of active participants reported on line 7a of the Form 55002015-01-01131
Total of all active and inactive participants2015-01-01131

Form 5500 Responses for SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN

2022: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SUBARU OF NEW ENGLAND AND AFFILIATES HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number0150850000
Policy instance 7
Insurance contract or identification number0150850000
Number of Individuals Covered345
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,017
Total amount of fees paid to insurance companyUSD $1,176
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,017
Amount paid for insurance broker fees1176
Additional information about fees paid to insurance brokerOTHER COMPENSATION PAID
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238345
Policy instance 1
Insurance contract or identification number000010238345
Number of Individuals Covered145
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $329
Total amount of fees paid to insurance companyUSD $36
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $329
Amount paid for insurance broker fees36
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238346
Policy instance 2
Insurance contract or identification number000010238346
Number of Individuals Covered24
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,869
Total amount of fees paid to insurance companyUSD $205
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,869
Amount paid for insurance broker fees205
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238347
Policy instance 3
Insurance contract or identification number000010238347
Number of Individuals Covered53
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,524
Total amount of fees paid to insurance companyUSD $135
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,524
Amount paid for insurance broker fees135
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 4
Insurance contract or identification numberE4009411
Number of Individuals Covered44
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,805
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $33,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,384
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10210461001
Policy instance 5
Insurance contract or identification number10210461001
Number of Individuals Covered159
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,068
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $888
Insurance broker organization code?3
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
Policy contract number46023000
Policy instance 6
Insurance contract or identification number46023000
Number of Individuals Covered348
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $33,462
Total amount of fees paid to insurance companyUSD $16,392
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,235,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,462
Amount paid for insurance broker fees16392
Additional information about fees paid to insurance brokerOTHER COMPENSATION PAID
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238345
Policy instance 1
Insurance contract or identification number000010238345
Number of Individuals Covered144
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $359
Total amount of fees paid to insurance companyUSD $69
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $7,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $359
Amount paid for insurance broker fees69
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238346
Policy instance 2
Insurance contract or identification number000010238346
Number of Individuals Covered34
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $6,141
Total amount of fees paid to insurance companyUSD $352
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,141
Amount paid for insurance broker fees352
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238347
Policy instance 3
Insurance contract or identification number000010238347
Number of Individuals Covered60
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,037
Total amount of fees paid to insurance companyUSD $260
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,037
Amount paid for insurance broker fees260
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 4
Insurance contract or identification numberE4009411
Number of Individuals Covered47
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,230
Total amount of fees paid to insurance companyUSD $271
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $42,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,517
Insurance broker organization code?3
Amount paid for insurance broker fees63
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10210461001
Policy instance 5
Insurance contract or identification number10210461001
Number of Individuals Covered148
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,167
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,167
Insurance broker organization code?3
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
Policy contract number46023000
Policy instance 6
Insurance contract or identification number46023000
Number of Individuals Covered354
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $41,890
Total amount of fees paid to insurance companyUSD $34,480
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,187,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,890
Amount paid for insurance broker fees34480
Additional information about fees paid to insurance brokerOTHER COMPENSATION PAID
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number0150850000
Policy instance 7
Insurance contract or identification number0150850000
Number of Individuals Covered351
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,276
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,276
Insurance broker organization code?3
DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
Policy contract number0150850000
Policy instance 7
Insurance contract or identification number0150850000
Number of Individuals Covered374
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $8,508
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $175,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,508
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10210461001
Policy instance 5
Insurance contract or identification number10210461001
Number of Individuals Covered152
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,035
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,035
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 4
Insurance contract or identification numberE4009411
Number of Individuals Covered53
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,548
Total amount of fees paid to insurance companyUSD $70
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $39,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,273
Insurance broker organization code?3
Amount paid for insurance broker fees14
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238347
Policy instance 3
Insurance contract or identification number000010238347
Number of Individuals Covered65
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,902
Total amount of fees paid to insurance companyUSD $65
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,902
Amount paid for insurance broker fees65
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238346
Policy instance 2
Insurance contract or identification number000010238346
Number of Individuals Covered36
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,278
Total amount of fees paid to insurance companyUSD $93
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,278
Amount paid for insurance broker fees93
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238345
Policy instance 1
Insurance contract or identification number000010238345
Number of Individuals Covered151
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $344
Total amount of fees paid to insurance companyUSD $17
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $344
Amount paid for insurance broker fees17
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
TUFTS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60117 )
Policy contract number46023000
Policy instance 6
Insurance contract or identification number46023000
Number of Individuals Covered377
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $42,757
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,462,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,757
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10210461001
Policy instance 6
Insurance contract or identification number10210461001
Number of Individuals Covered130
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $792
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $792
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 5
Insurance contract or identification numberE4009411
Number of Individuals Covered58
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,523
Total amount of fees paid to insurance companyUSD $328
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $42,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,732
Insurance broker organization code?3
Amount paid for insurance broker fees49
Additional information about fees paid to insurance brokerBONUS AND NON CASH INCENTIVES
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957962
Policy instance 4
Insurance contract or identification number4957962
Number of Individuals Covered389
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $49,732
Total amount of fees paid to insurance companyUSD $15,113
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,849,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,732
Amount paid for insurance broker fees15113
Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238347
Policy instance 3
Insurance contract or identification number000010238347
Number of Individuals Covered71
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,907
Total amount of fees paid to insurance companyUSD $65
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,907
Amount paid for insurance broker fees65
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238346
Policy instance 2
Insurance contract or identification number000010238346
Number of Individuals Covered39
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,592
Total amount of fees paid to insurance companyUSD $83
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,592
Amount paid for insurance broker fees83
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238345
Policy instance 1
Insurance contract or identification number000010238345
Number of Individuals Covered157
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $348
Total amount of fees paid to insurance companyUSD $17
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $348
Amount paid for insurance broker fees17
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238345
Policy instance 1
Insurance contract or identification number000010238345
Number of Individuals Covered154
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $336
Total amount of fees paid to insurance companyUSD $405
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $336
Amount paid for insurance broker fees405
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238346
Policy instance 2
Insurance contract or identification number000010238346
Number of Individuals Covered41
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,009
Total amount of fees paid to insurance companyUSD $433
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,009
Amount paid for insurance broker fees433
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010238347
Policy instance 3
Insurance contract or identification number000010238347
Number of Individuals Covered77
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,878
Total amount of fees paid to insurance companyUSD $1,597
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,878
Amount paid for insurance broker fees1597
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957962
Policy instance 4
Insurance contract or identification number4957962
Number of Individuals Covered387
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $47,707
Total amount of fees paid to insurance companyUSD $13,473
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,672,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,707
Amount paid for insurance broker fees13473
Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 5
Insurance contract or identification numberE4009411
Number of Individuals Covered64
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,502
Total amount of fees paid to insurance companyUSD $858
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $42,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,060
Insurance broker organization code?3
Amount paid for insurance broker fees276
Additional information about fees paid to insurance brokerBONUS AND NON CASH INCENTIVES
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010065288
Policy instance 1
Insurance contract or identification number000010065288
Number of Individuals Covered117
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $296
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $296
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FL
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400002000
Policy instance 2
Insurance contract or identification number000400002000
Number of Individuals Covered117
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,049
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,049
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMSA05566
Policy instance 3
Insurance contract or identification numberMSA05566
Number of Individuals Covered32
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,636
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,636
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA LLC D/B/A UNITE
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957962
Policy instance 4
Insurance contract or identification number4957962
Number of Individuals Covered394
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $100,220
Total amount of fees paid to insurance companyUSD $13,410
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,455,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,220
Amount paid for insurance broker fees13410
Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA LLC
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4009411
Policy instance 5
Insurance contract or identification numberE4009411
Number of Individuals Covered65
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,238
Total amount of fees paid to insurance companyUSD $1,103
Other welfare benefits providedMEDICAL BRIDGE & ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $38,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,941
Insurance broker organization code?3
Amount paid for insurance broker fees457
Additional information about fees paid to insurance brokerBONUS AND NON CAHS INCENTIVES
Insurance broker nameFALVEY BENEFIT ADVISORS INC
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957962
Policy instance 4
Insurance contract or identification number4957962
Number of Individuals Covered326
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,680,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMSA05566
Policy instance 3
Insurance contract or identification numberMSA05566
Number of Individuals Covered32
Insurance policy start date2015-11-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,697
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,697
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA LLC D/B/A UNITE
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400002000
Policy instance 2
Insurance contract or identification number000400002000
Number of Individuals Covered109
Insurance policy start date2015-11-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,064
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,064
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010065288
Policy instance 1
Insurance contract or identification number000010065288
Number of Individuals Covered61
Insurance policy start date2015-11-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $165
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $19,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $165
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF FL

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